Treatments For Uterine Prolapse

Uterine Prolapse can be treated with non-surgical options or surgical options. Talk to your health care provider to see which treatment is best for your condition.

Non-Surgical Options

There are a number of non surgical options that are available for you to discuss with your physician.

 

Kegel Exercises

Special exercises, called Kegel exercises, can help strengthen the pelvic floor muscles. This may be the only treatment needed in mild cases of uterine prolapse. To do Kegel exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat. You may do these exercises anywhere and at any time. To see results, it is recommended that you repeat the exercise four times daily.10

 

Vaginal Pessary

A pessary is a rubber or plastic doughnut-shaped device that fits around or under the lower part of the uterus (cervix), helping to prop up the uterus and hold it in place. A health care provider will fit and insert the pessary, which must be cleaned frequently and removed before sex.10

 

Estrogen Replacement Therapy

ERT refers to a woman taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone (progestin in its synthetic form). ERT replaces hormones that a woman’s body should be making or used to make.2 Taking estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus. However, there are some drawbacks to taking estrogen, such as an increased risk of blood clots, gallbladder disease and breast cancer. The decision to use ERT must be made with your doctor after carefully weighing all of the risks and benefits.11

Surgical Options

Hysterectomy
Uterine prolapse may be treated by removing the uterus in a surgical procedure called hysterectomy. This may be done through an incision made in the vagina (vaginal hysterectomy), through the abdomen (abdominal hysterectomy) or minimal invasive surgery with small incisions through the abdomen. Hysterectomy is a major surgery, and removing the uterus means pregnancy is no longer possible.

 

Learn More on Hysterectomy

Uterine Suspension
Uterine suspension is a procedure that involves putting the uterus back into its normal position. This may be done by reattaching the pelvic ligaments to the lower part of the uterus to hold it in place. Another technique uses a special material that acts like a sling to support the uterus in its proper position. Recent advances include performing uterine suspension with minimally invasive techniques and laparoscopically (through small band aid-sized incisions) that decrease post-operative pain and speed recovery.1


Sacrocolpopexy is a procedure to surgically correct vaginal vault prolapse where mesh is used to hold the vagina in the correct anatomical position. This procedure can also be performed following a hysterectomy to treat uterine prolapse to provide long-term support of the vagina.

 

Sacrocolpopexy has traditionally been performed as an open surgery. A 6 to 12 inches horizontal incision is made in the lower abdomen in order to manually access the inter-abdominal organs, including the uterus.

 

da Vinci Sacrocolpopexy

This minimally invasive procedure is performed through small incisions using the state-of-the-art da Vinci Surgical System, a breakthrough surgical platform which enables gynecologists to operate with unmatched precision, dexterity and control. da Vinci Sacrocolpopexy, combines the advantages of conventional open and minimally invasive surgery – but with potentially fewer drawbacks.

 

da Vinci Sacrocolpopexy offers numerous potential benefits over traditional approaches, including:

 

  • Significantly less pain6
  • Minimal blood loss and need for transfusion7,8
  • Fewer complications8,9
  • Shorter hospital stay8,9
  • Quicker recovery and return to normal activities5,6
  • Small incisions for minimal scarring
  • Better outcomes and patient satisfaction, in many cases8

 

  1. Center for Disease Control. Keshavarz H, Hillis S, Kieke B, Marchbanks P. Hysterectomy Surveillance — United States, 1994–1999. Morbidity and Mortality Weekly Report. Surveillance Summaries. July 12, 2002. Vol. 51 / SS-5. Page 1. www.cdc.gov/mmwr/PDF/ss/ss5105.pdf
  2. Harmanli OH, Khilnani R, Dandolu V, Chatwani AJ. Narrow pubic arch and increased risk of failure for vaginal hysterectomy. Obstet Gynecol. 2004 Oct; 104(4):697-700.
  3. Paparella P, Sizzi O, Rossetti A, De Benedittis F, Paparella R. Vaginal hysterectomy in generally considered contraindications to vaginal surgery. Arch Gynecol Obstet. 2004 Sep; 270(2):104-9. Epub 2003 Jul 10.
  4. Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R. Methods of hysterectomy: systematic review andmeta-analysis of randomised controlled trials. BMJ. 2005 Jun 25; 330(7506):1478. Review.
  5. http://www.merck.com/mmhe/sec22/ch242/ch242b.html#sec22-ch242-ch242b-83
  6. http://www.nccn.org/patients/patient_gls/_english/_pain/2_assessment.asp
  7. http://www.merck.com/mmhe/sec22/ch252/ch252f.html?qt=pain%20during%20intercourse&alt=sh
  8. Boggess JF. Robotic surgery in gynecologic oncology: evolution of a new surgical paradigm. J Robotic Surg 2007 1:31-3
  9. Payne TN, et al. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol. 2008 May-June;15(3):286-91
  10. "Uterine Prolapse," The Cleveland Clinic Health Information Center, www.clevelandclinic.org. URL:   http://www.clevelandclinic.org/health/health-info/docs/2600/2662.asp?index=9782
  11. "Estrogen Replacement Therapy (ERT)," National Institute of Child Health & Human Development. www.nichd.hih.gov. URL: http://www.nichd.nih.gov/health/topics/estrogen_replacement_therapy.cfm

 


While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.