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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons
Vaginal prolapse surgery is an invasive surgical treatment designed to repair either the front or rear vaginal walls. The treatment returns the vagina to its natural position, repairs the wall tissues and strengthens the vagina to help prevent a prolapse from recurring.
A prolapse occurs when one or more of the pelvic organs bulge into the wall of the vagina. This collection of organs includes the bladder, uterus, bowel and cervix. A prolapse can affect the front, back or top of the vagina, or sometimes all three at the same time. Pelvic organ prolapse severity is classified on a scale of 1 to 4, with 4 being a severe prolapse.
There are several different types of prolapse surgery depending on the type of prolapse and its severity. Your surgeon will discuss all the available options with you to decide which prolapse treatment will be best suited to you.
Please note that we do not offer vaginal mesh surgery, which involves a piece of synthetic mesh inserted into the vagina to hold the pelvic organs in place. Some women have experienced serious complications after mesh surgery, such as long-lasting pain, permanent nerve damage and damage to the surrounding organs. Instead we favour using the patient's natural tissues and sutures to strengthen the pelvic floor and keep pelvic organs in their intended position.
Time off work
4 - 6 week
After 1 day
After 1 day
8 - 12 weeks
After 6 weeks
Sleeping on back
6 - 12 weeks
4 - 6 weeks
Vaginal prolapse, depending on its severity, can be a difficult condition to live with. Women who have pelvic organ prolapse can experience frequent pain or discomfort, including a heavy or ‘dragging’ feeling around the lower stomach and genitals. This pain or discomfort can have a huge impact on your mental health and wellbeing, to the extent that you may be experiencing anxiety or depression.
Pelvic organ prolapse can also cause problems with urination, such as stress incontinence, an increased urgency when you go to the toilet or problems emptying your bladder. This can be embarrassing and you may find that these changes in your toilet habits can impact on your ability to carry out your normal day-to-day activities.
Pelvic organ prolapse can cause pain or discomfort during sex or, if the prolapse is particularly severe, it can prevent sexual intercourse all together. If the prolapse bulge is visible in or out of the vagina, then this can be a source of embarrassment, and in some cases may cause a woman to avoid intimate relationships altogether.
As well as the physical symptoms, the effects of a pelvic prolapse can impact on your sexual and romantic relationships, your social life, self-confidence, self-esteem and overall mental wellbeing. Prolapse surgery can effectively tackle the problems that come with pelvic organ prolapse and greatly improve your quality of life.
People often turn to prolapse surgery if other forms of prolapse treatment have failed.
Cadogan Clinic considers individuals fit for prolapse surgery if all of the following are true of them:
You may also be experiencing one or more of the following:
If you are planning another pregnancy, you may wish to consider waiting until you have completed your family. If you go on to have another pregnancy after your surgery, this may affect the result and you may need to repeat the surgery at a later date.
Words from our clients:
"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."Eva Berry
"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"Scarlett Elliott
"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."Georgina Nolan
“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."Courtney O'Sullivan
"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."Gemma Stevenson
"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."Emma Davies
There are several different surgical options for treating vaginal prolapse. Your surgeon will discuss these with you at your initial consultation to help identify which option will be best for you.
Native tissue repair
This type of surgery uses the patient’s own natural tissues to treat vaginal or uterine prolapse. The surgeon will make an incision in the vagina before stitching the prolapsed part to a ligament or muscle in the pelvis to return it to its previous position.
Women with a prolapsed uterus, who are post-menopausal or do not plan on having any more children, may be suitable for a hysterectomy (removal of the uterus).
This can help to relieve the pressure on the vainal walls, cutting the chance of a prolapse recurring.
There are different types of hysterectomies and some involve also removing the cervix or ovaries or both.
Anterior or posterior colporrhaphy
This is used to treat vaginal wall prolapse in the front (anterior) or back (posterior) vaginal wall. The surgery is done through the vagina. The surgeon will use stitches to strengthen the vagina, so it is once again able to support the bladder and rectum.
Closing the vagina
Also known as obliterative surgery, this particular prolapse treatment involves closing off some or all of the vagina. It is an effective prolapse treatment, but by closing off the vagina, you will not be able to have penatrative sex again. This prolapse surgery is really only suitable for women who have advanced prolapse, where no other treatments have worked, and they are certain they do not want to have sex again.
We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.
Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.
Your journey with the Cadogan Clinic will start with up to two consultations with one of our leading specialist plastic surgeons at our award-winning premises in Chelsea. These consultations will take between 30 and 60 minutes.
During your consultation, your surgeon will ask about your expectations for your prolapse surgery and talk about what will happen during the procedure. They will also explain how the procedure will affect you and the recovery period.
It is important that you are open and honest about what you hope to achieve through surgery to help ensure the best possible result. Your surgeon will be happy to answer any questions you may have at this point. It may be a good idea to write your questions down before attending the consultation. Having established what you want from the surgery, and what is possible given your anatomy, several key measurements will be made and standard clinical photography will be taken. Your medical history will be discussed and a physical examination will be carried out.
If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed with your prolapse treatment or not following a two week 'cooling off' period.
02.Leading up to Procedure
If you decide to go ahead with surgery, the next time you will return to the clinic is on the day of your hoodectomy. It is important that you prepare by taking the following measures ahead of surgery.
In the six hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid which will be allowed up to two hours before you are admitted to the clinic. Clear fluids include still water, black coffee and black tea.
03.On the day
Your prolapse surgery will take place at our award-winning clinic in Chelsea.
You will be given a general anaesthetic to put you to sleep for the operation.
The surgeon will make an incision into the vagina and will proceed to tighten the surrounding muscles and tissues to lift and support the pelvic organs. The surgeon may also make repairs to the front and rear walls of your vagina, depending on the nature of your prolapse. Cuts in the vaginal wall are closed with dissolvable stitches. This means you will not have to return to the clinic to have any sutures removed.
The length of the procedure depends on the extent of your prolapse.
Following your prolapse surgery, you will recover in our ambulatory recovery rooms. You may feel a little drowsy but this often wears off within a few hours. Once you are able to eat and drink, and our specialist nursing team are happy that your initial recovery is complete, you will be allowed to leave the clinic with a friend or family member.
As this surgery involves a very delicate area of the body, you will likely experience some mild pain or discomfort in the aftermath of your prolapse surgery. You may experience some vaginal bleeding or discharge in the days following your prolapse surgery. This may last for up to two weeks.
The recovery time depends on which type of prolapse surgery you have. It may take anywhere between six and 12 weeks for you to make a full recovery.
After surgery, you should eat a healthy diet and take laxatives in order to prevent constipation and avoid straining when you go to the toilet. You should avoid driving for four to six weeks after surgery as performing an emergency stop may cause pain to the treatment area.
You won’t be able to lift anything heavy for eight to 12 weeks and you will need to take four to six weeks off work, depending on the type of job you do.
Our on-call nursing service is open 24/7 during your recovery period to help with any questions or queries that you may have.
It is important that you follow all the aftercare instructions issued by your doctor. Failure to do so may impact on your recovery and the final result.
The Patient Journey. A breakdown of what you can expect on your journey with us
We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journeyThe Patient Journey
What causes vaginal prolapse?
Vaginal prolapse happens when the pelvic floor, which holds the pelvic organs in place, is weakened and therefore unable to support these organs in their original position.
There are a number of things that can cause vaginal prolapse:
People with certain long-term health conditions are also more susceptible to pelvic organ prolapse. These include people with joint hypermobility syndrome, Marfan syndrome (a disorder of the body's connective tissues) and Ehlers-Danlos syndromes (a group of rare inherited conditions that affect connective tissue).
How long does it take to recover from prolapse surgery?
It depends on which type of surgical prolapse treatment you have, but a full recovery can take anywhere between six and 12 weeks.
You may experience bleeding and vaginal discharge for a couple of weeks following your prolapse surgery. You should use sanitary towels rather than tampons during this time.
You should be able to shower and bathe as normal after your surgery, but you should avoid swimming for several weeks afterwards.
Driving should be avoided for four to six weeks, heavy lifting should be avoided for eight to 12 weeks and you will need to take four to six weeks off work, depending on the type of job you do.
What lifestyle changes can help reduce the risk of prolapse?
There are certain lifestyle changes which can reduce the risk of prolapse or reduce the likelihood of prolapse recurring. If your prolapse is mild, making these lifestyle changes could prevent your prolapse from getting worse.
If you are overweight, you should try to lose weight to relieve some of the pressure on your pelvic floor. Eating a high-fibre diet will help you to avoid constipation and straining when going to the toilet. You should also avoid lifting heavy objects where possible.
Doing pelvic floor exercises several times a day to strengthen the muscles may help and this can even relieve some symptoms, for example, by stopping stress incontinence.
What are the side effects and risks of treatment?
Vaginal prolapse treatment is a safe surgical procedure. But just like any other surgeries, there are risks attached.
Risks of prolapse surgery include; bleeding and vaginal discharge, damage to the surrounding organs (such as the bowel or bladder), infection and temporary discomfort duing sex. Very occasionally a woman who has had prolapse treatment may go on to experience more prolapse symptoms. If this is the case, then further surgery may be required.
Any type of operation also carries a risk of excessive bleeding, developing a blood clot in a vein,
infection or an allergic reaction to the anaesthetic. However the risk of any of these happening during your prolapse treatment is small.
How soon after prolapse surgery can I resume sexual activity?
You should refrain from any sexual activity for four to six weeks after your prolapse surgery. You should only return to sexual activity when you feel ready to do so. If you find that sexual activity causes pain or discomfort, stop and try again after more time has passed.
It is important that you rest and allow yourself time to recover. You must follow all the after care instructions issued by your surgeon in order to achieve the best result and ensure a swift recovery.
If you have had obliterative surgery (surgery to close the vagina) you will no longer be able to have penitatrive sex.
Will a vaginal pessary treat vaginal prolapse?
A pessary can be used as a vaginal prolapse treatment. These rubber or silicone devices are inserted into the vagina and left in place to support the vaginal walls and the pelvic organs. They are a non-surgical alternative for women who are experiencing moderate or severe prolapses.
However this is not a permanent solution and the pessary will need to be removed, cleaned and replaced regularly by a gynaecologist or a specialist nurse.
Common side effects of vaginal pessaries can include irritation inside the vagina, urinary tract infections, an unpleasant smell coming from the vagina and stress incontinence.
What are the different types of pelvic organ prolapse?
There are several different types of pelvic organ prolapse. You may experience one, some or all of the following types:
Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.
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