At UVA, we first try non-surgical treatments to correct your prolapse. If your problem persists, we'll try surgical treatment.
Non-Surgical Treatments for Pelvic Organ Prolapse
Your doctor may suggest you:
- Avoid standing for long periods of time.
- Avoid heavy lifting.
- Keep your bowel movements soft using a high fiber diet.
- Use pessaries, a small device made of plastic or silicone that is placed inside the vagina to hold the uterus or the walls of the vagina up and inside of your body.
- Perform pelvic floor muscle training (Kegels) to help with pelvic support.
Treating Urinary Incontinence Without Surgery
Fluid Management
- Decrease your intake of fluids to a total of 50-60 ounces per day provided you don’t have a medical condition that prohibits limiting fluids.
- Avoid or decrease certain types of fluids, including caffeinated beverages (e.g., soda, teas and coffee), alcohol or acidic juices (e.g., grapefruit or orange juice).
Bladder Training
There are different types of bladder training that can improve your symptoms of stress and urge incontinence.
- Classic bladder training (habit training): This type of training can be helpful if you have symptoms of an overactive bladder (urgency, frequency or urge incontinence). You'll first keep a bladder diary and then set up a voiding schedule to slowly increase the time between urination. You can increase your voiding time by 15 minutes every week with the goal of urinating every 2-3 hours. This training teaches you to suppress the urge to void before the scheduled time. Performing pelvic floor contractions (Kegels) can also help suppress the urge.
- Timed voiding: During this training, your doctor sets times for you to empty your bladder. This is commonly used with medication for overactive bladder.
- Prompted voiding: Your caregiver prompts you to go to the bathroom on a regular schedule, every 2-4 hours. The goal is simply to keep you dry. This therapy is common for frail elderly, bedridden or Alzheimer's patients.
- Pelvic muscle rehabilitation (Kegel exercises): Pelvic muscle exercises (PME) can be used alone or in conjunction with biofeedback therapy, vaginal weight training and pelvic floor stimulation.
- Pessaries: A pessary is a device worn in the vagina to help support the prolapsed organ. While it may ease your symptoms, it does not repair the prolapse. A pessary can be taken in and out either on a daily, weekly or monthly basis. Pessaries come in many different shapes and sizes and must be fitted by a doctor.
Your doctor may prescribe medication by itself or in conjunction with other non-surgical treatment options.