Uterine prolapse (pelvic organ prolapse)
A heavy feeling, vaginal pressure or a noticeable bulge may indicate prolapse. An accurate diagnosis is the first step towards treatment suited to the type and severity of your symptoms.
When pelvic floor support weakens
The pelvic floor consists of muscles, connective tissue and ligaments that support the organs in the pelvis. When this support weakens or is damaged, an organ can descend towards the vagina. This is called pelvic organ prolapse or POP.
It does not always involve the uterus. The bladder, rectum, vaginal vault after hysterectomy, or several structures at once may also prolapse. An examination is therefore needed to establish exactly what is happening.
Not every prolapse is the same
Anterior wall
The bladder descends against the front wall of the vagina. This is often called a cystocele and may be associated with urinary problems.
Uterus or vaginal vault
The uterus descends, or the top of the vagina loses support after a hysterectomy.
Posterior wall
The rectum bulges against the back wall of the vagina. This is called a rectocele and may make bowel movements more difficult.
What might you notice?
The stage found on examination does not always match the amount of discomfort. A mild prolapse may cause symptoms, while a more pronounced prolapse can sometimes cause little discomfort.
- a heavy, dragging or pressing sensation in the pelvis;
- feeling or seeing a bulge at the vaginal opening;
- symptoms that increase with prolonged standing, coughing, lifting or straining;
- difficulty emptying the bladder, urinating more often or urinary leakage;
- difficult bowel movements or a feeling of incomplete emptying;
- discomfort during movement, tampon use or sexual intercourse.
Treatment starts with the right diagnosis
A doctor assesses which structure has prolapsed, how far it descends and which symptoms are associated with it. This often involves a gynaecological examination while you bear down. Urinary and bowel symptoms are assessed separately.
Mild
The lowest point remains well above the vaginal opening.
At the opening
The prolapse reaches approximately the vaginal opening.
Beyond the opening
A substantial part extends beyond the vaginal opening.
Complete
The vagina or uterus has almost completely descended outside the body.
The choice between monitoring and treatment depends mainly on your symptoms, examination, health, future pregnancy plans and personal preference. A prolapse that causes no discomfort does not automatically require treatment.
From pelvic floor therapy to surgery
Treatment is tailored to your symptoms, the type of prolapse and its severity. Within this overview, Belgian Beauty Clinic provides laser therapy . For pelvic floor therapy, a pessary or surgical repair, we refer you to the appropriate healthcare professional.
Pelvic floor therapy
For mild to moderate symptoms, specialist pelvic floor physiotherapy can improve muscle function and reduce symptoms. Treating constipation, lifting correctly and maintaining a healthy weight may also reduce pressure on the pelvic floor.
Pessary
A pessary is a removable device placed in the vagina to support the prolapsed structures. It must be fitted correctly and checked regularly.
Surgical repair
For pronounced or troublesome symptoms, a gynaecologist or urogynaecologist may discuss surgery. The technique depends on the affected compartment, previous procedures and your preferences.
Laser therapy
For grade 1 to mild grade 3 prolapse, non-ablative Er:YAG laser therapy may be considered. The treatment stimulates the supporting tissue of the vaginal wall and may reduce prolapse symptoms without surgery or incisions.
Laser therapy for mild to moderate prolapse
The non-ablative Er:YAG laser delivers controlled heat to the vaginal wall. Existing collagen fibres contract and the natural production and remodelling of collagen are stimulated. This may strengthen the supporting tissue and reduce pressure and other prolapse symptoms.
Research shows that Er:YAG laser therapy for mild to moderate prolapse can effectively improve symptoms. In a randomised study, improvement was comparable to specialist pelvic floor therapy. In our practice, treatment may be considered for grade 1 to mild grade 3, following careful assessment.
Because the treatment is non-surgical, it may provide a suitable intermediate step and help postpone a possible operation. Results vary between patients and maintenance treatment may be needed over time. Pronounced grade 3 or grade 4 prolapse should first be assessed by a gynaecologist or urogynaecologist.
A careful and discreet pathway
- prior assessment of symptoms and medical history;
- treatment outside menstruation and not in the presence of an active vaginal infection;
- a smooth vaginal handpiece delivering controlled Er:YAG pulses;
- usually a warm or mildly uncomfortable sensation;
- home the same day with personalised aftercare instructions.
A temporary increase in discharge, mild irritation or a burning sensation may occur. Sexual intercourse is discouraged for one week. Contact us in case of pain, bleeding, fever, pronounced irritation or abnormal discharge.
Have new or obvious symptoms assessed
if you have a visible or noticeable bulge, unexplained vaginal bleeding, pain, recurrent urinary tract infections, difficulty urinating or passing stool, or rapidly worsening symptoms. Sudden inability to urinate, severe pain or heavy bleeding requires prompt medical assessment.
Prolapse or vaginal laxity?
With prolapse, a pelvic organ descends towards or into the vagina. Vaginal laxity mainly involves a feeling of reduced firmness or looseness, without necessarily having organ prolapse. Symptoms may overlap, but diagnosis and treatment differ.
Good to know
Is uterine prolapse the same as pelvic organ prolapse?
Uterine prolapse is one type of pelvic organ prolapse. The bladder, rectum or vaginal vault may also prolapse, either alone or together with other structures.
Can prolapse resolve on its own?
After childbirth, support and symptoms may still improve during the first few months. Established anatomical prolapse usually does not disappear completely on its own, although symptoms may fluctuate and improve with conservative treatment.
Can pelvic floor therapy cure prolapse?
Pelvic floor therapy can improve muscle function and symptoms, particularly in mild to moderate prolapse. It cannot always restore damaged supporting tissue and does not eliminate the need for surgery or a pessary in every case.
Can laser treat grade 3 prolapse?
For mild grade 3 prolapse, laser therapy may be considered after careful assessment. More pronounced grade 3 or grade 4 prolapse should first be assessed by a gynaecologist or urogynaecologist.
How many laser sessions are needed?
When laser is considered appropriate after medical assessment, an individual treatment plan is discussed. A course of sessions is often used, but we cannot promise a fixed result or permanent effect.
Can vaginal laser treatment take place during menstruation?
No. Vaginal laser treatment is scheduled outside menstruation. An active vaginal infection must be treated first.
Can I have sex after treatment?
We advise avoiding sexual intercourse for one week and following the personalised aftercare instructions.
Have your symptoms assessed correctly
We listen in complete discretion and explain honestly which next step is appropriate. If a gynaecological or urogynaecological assessment is indicated, we will say so clearly.
Our locations
Consultations at three locations. Procedures take place at our clinic in Diest.
Not every treatment is available at every location. View available appointments.