Treatment approaches depend on the severity of the posterior prolapse. Options include:
- Observation. If your posterior prolapse causes few or no obvious symptoms, you may not need treatment. Simple self-care measures, such as performing exercises called Kegels to strengthen your pelvic muscles, may provide symptom relief.
- Pessary. A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bulging tissues. Several types of pessaries are available, including some you can remove to clean, and others your doctor must remove periodically to clean.
- Surgery. If the posterior prolapse protrudes outside your vagina and is especially bothersome, you may opt for surgery. Surgery to repair posterior prolapse will repair the tissue bulge, but it won't fix impaired bowel function.
Your doctor will likely suggest surgery if you have anterior, apical or uterine prolapse in addition to posterior prolapse. In these cases, surgical repair for each condition can be completed at the same time.
Using a vaginal approach, surgery usually consists of removing excess, stretched tissue that forms the posterior prolapse. Occasionally, the surgical repair may involve using a mesh patch to support and strengthen the wall between the rectum and vagina.
If you're thinking about becoming pregnant, delay surgery until after you're done having children. Using a pessary may help relieve your symptoms in the meantime.
Aug. 01, 2012
- Park AJ, et al. Clinical manifestations, diagnosis, and nonsurgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed May 31, 2012.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed June 4, 2012.
- Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstetrics & Gynecology. 2012;119:852.
- Park AJ, et al. Surgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed June 5, 2012.
- Rogers RG, et al. An overview of the epidemiology, risk factors, clinical manifestations, and management of pelvic organ prolapse in women. http://www.uptodate.com/index. Accessed June 5, 2012.
- Hagen S, et al. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology and Reproductive Medicine. 2012;22:118.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. July 5, 2012.