Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a common condition affecting many women who have sustained childbirth damage. As prolapse tends to progress with age and as life expectancy improves, more and more women are affected and are expected to seek help for this condition.

Prolapse can affect any of the pelvic organs – the bowels, the bladder, the uterus. The condition usually manifests as a visible lump through the vagina with or without disturbances to normal bladder, bowel or sexual functions.

While not life-threatening, pelvic organ prolapse with associated functional disturbance can affect womens quality of life, body image and self-confidence.

Conservative and surgical treatment options are available.

Non-surgical treatments for pelvic organ prolapse include:
  • Pelvic floor exercises
  • Correction of aggravating factors heavy lifting, chronic coughing, chronic constipation
  • Hormone replacement therapy
  • Vaginal pessary
The aims of surgery are:
  • to identify and repair the damaged connective tissues and pelvic floor muscles
  • to restore the prolapsed organs to their normal position
  • to improve or restore their functions to normal

There are many different types of operations for pelvic organ prolapse (POP). These can be broadly divided according to:

  • the sites of repair: anterior (cystocoele or bladder prolapse), posterior (rectocoele  or rectal prolapse), apex (uterine or vaginal vault prolapse)
  • the materials used:  patient’s own tissue (natural or native tissue), biological (porcine, bovine), synthetic (prolene)
  • the surgical route: transvaginal, laparoscopic or abdominal
  • the anatomical landmarks of attachment of the prolapsed organ: sacrospinous ligament fixation, sacrocolpopexy

Modern minimal access surgical techniques such as laparoscopic or robotic sacrocolpopexy combined with the use of newly designed soft meshes can be considered in selected cases of severe, recurrent pelvic organ prolapse to deliver excellent long-term results with minimal morbidity. 

Is hysterectomy neccessary for repair of pelvic organ prolapse?  

While hysterectomy is often advised as part of surgery for POP, there is no evidence to suggest that removal of a normal  (non-diseased, non-prolapsed) uterus actually improves outcomes. Hysterectomy could inadvertently cause unintended neuro-vascular trauma to the already damaged pelvic floor with consequent increased risks of bladder, bowel, coital functional disturbance as well as increasing the risk of vaginal vault prolapse. Hysterectomy can therefore be avoided without compromising the chance of successful repair in the majority of cases.

CARE experience

Our highly experienced surgeons have successfully treated thousands of women with significant, troublesome pelvic organ prolapse. Due to our extensive experience, we often see women with severe, recurrent prolapse who have been through several previous unsuccessful surgical repairs.

At CARE, we have been actively involved in clinical research activities and ongoing audits to assess efficacy and safety of the wide range of surgical techniques and diverse materials used for surgical management of pelvic organ prolapse. Our fellows have presented CARE data at many national and internationational conferences over the years. 

For more information, please refer to the following information pamphlet CARE Sacrocolpopexy

For appointment, please call us on 9966 9121