Management of uterine prolapse :
• One of the most important decisions to consider is the appropriate
treatment for prolapse in a young woman following childbirth.
• If the operation is performed within 6 months of delivery, there is always
the possibility of recurrence of prolapse.
• Besides, these women rapidly improve if well-directed conservative
measures are adopted. Abdominal exercises, massage and perineal
exercises practised early and strenuously, will prevent or reduce
prolapse.
• Conservative measures should be advised following delivery for 3 to 4
months.
Surgery is advised in women over 40 unless it is contraindicated or is
hazardous on account of some medical disorders.
It is also contraindicated during pregnancy.
Pessary Treatment of Prolapse :
• The ring pessary for prolapse is nearly a thing of the past when majority
of elderly women and very young women desirous of childbearing
received this treatment.
• With modern anaesthesia and good preoperative care, advanced age is
no longer a contraindication to permanent surgical procedure.
The pessary treatment of prolapse has certain limitations:
1) It is never curative and can only be palliative.
2) It can cause vaginitis.
3) Pessary needs to be changed every 3 months.
4) The wearing of a pessary is not comfortable to some women and may
cause dyspareunia.
5) If the vaginal orifice is very patulous, the pessary is often not retained.
6) A forgotten pessary can be the cause of ulcer, and in rare cases,
carcinoma of the vagina and a vesicovaginal fistula.
7) A pessary does not cure urinary stress incontinence.
• One of the most important decisions to consider is the appropriate
treatment for prolapse in a young woman following childbirth.
• If the operation is performed within 6 months of delivery, there is always
the possibility of recurrence of prolapse.
• Besides, these women rapidly improve if well-directed conservative
measures are adopted. Abdominal exercises, massage and perineal
exercises practised early and strenuously, will prevent or reduce
prolapse.
• Conservative measures should be advised following delivery for 3 to 4
months.
Surgery is advised in women over 40 unless it is contraindicated or is
hazardous on account of some medical disorders.
It is also contraindicated during pregnancy.
Pessary Treatment of Prolapse :
• The ring pessary for prolapse is nearly a thing of the past when majority
of elderly women and very young women desirous of childbearing
received this treatment.
• With modern anaesthesia and good preoperative care, advanced age is
no longer a contraindication to permanent surgical procedure.
The pessary treatment of prolapse has certain limitations:
1) It is never curative and can only be palliative.
2) It can cause vaginitis.
3) Pessary needs to be changed every 3 months.
4) The wearing of a pessary is not comfortable to some women and may
cause dyspareunia.
5) If the vaginal orifice is very patulous, the pessary is often not retained.
6) A forgotten pessary can be the cause of ulcer, and in rare cases,
carcinoma of the vagina and a vesicovaginal fistula.
7) A pessary does not cure urinary stress incontinence.
