Safe Prolapse Management

Conservative Management of Prolapse

Pelvic organ prolapse is common, and some degree of prolapse is seen in 50% of parous women. Women with prolapse can experience a variety of pelvic floor symptoms. Treatments include

  • surgery,

  • mechanical devices (like a Sling), and

  • conservative management.

Mild to Moderate Prolapse

Patients with mild uterine prolapse do not require therapy because they are usually asymptomatic. While those women who do show symptoms of mild to moderate prolapse, use conservative management approaches, such as giving lifestyle advice and delivering pelvic floor muscle training.

Study Shows Improvement

Pelvic exercises (Kegel exercises) and pessaries are the current mainstays of nonsurgical management of patients.

There is some encouragement from a feasibility study involving 47 women that pelvic floor muscle training, delivered by a physiotherapist to symptomatic women in an outpatient setting, may reduce the severity of prolapse. However, there is no evidence that this treatment can lead to regression.

Sling Procedure

What Is A Minimally Invasive Sling Procedure?

Stress urinary incontinence is the inability to control the flow of urine, which leads to the leakage of urine when you sneeze, cough or laugh. A vaginal sling is a minimally invasive surgery performed to treat stress urinary incontinence.

  • Conventional sling: Sling made of body tissue or synthetic material, which is secured with stitches.

  • TVT-O is a mid-urethral sling that is used to treat female urinary incontinence. It offers more accurate delivery and control. It is quite safe and is a minimally invasive procedure that has minimal risk of tissue injury and bleeding. It is a mesh sling which is held in place with the surrounding tissue.

The sling is passed through the incision and secured under the urethra. This helps in lifting and supporting the urethra and bladder neck (where urethra meets the bladder).

About The Procedure

TVT-O placement is a relatively simple procedure requiring a short hospital stay with a quick recovery compared to retropubic suspension surgery.

The TVT-O provides support to the sagging urethra so that it remains closed during coughing or sudden movement, preventing the accidental leak of urine.

Inserting a TVT-O usually takes about 30 minutes and is performed under general anaesthesia. Dr Alexander will make small incisions over the vaginal wall.

Mesh tape is then passed under the urethra, like a hammock, to maintain its normal position. No stitches are required to keep the TVT-O in place. A catheter is inserted into the bladder to drain urine

Recovery After Tension-free Vaginal Tape Procedure

Patients undergoing TVT-O placement may experience slight pain and discomfort. Following the procedure, you will be asked to empty your bladder to see the reaction of the bladder and urethra to the surgery.

Patients may go home on the same day or the next day. A catheter (thin flexible tube) may be inserted in your bladder to drain the urine during the recovery period. Patients may resume normal activities within 1 to 2 weeks. However, you may need to avoid driving for 2 weeks, and sexual activity or strenuous activities for up to 6 weeks.

Possible Complications With Sling Procedures

As in all surgical procedures, the sling procedure may also be associated with certain complications, which include:

  • Urine infection

  • The synthetic material of the sling can be rejected by the vagina tissue (erosion)

  • Damage to the bladder, urethra or vagina, bleeding

  • Irritation in the bladder

  • Voiding dysfunction, difficulty emptying the bladder

Your Next Step

If you are experiencing prolapse Dr Alexander can offer advice on a possible diagnosis, further investigations and suitable treatment. Arrange an appointment now for peace of mind and body.

We would advise that you see your general practitioner and possibly obtain a referral to see Dr Alexander at www.alexalexander.com.au