Uterine or Vaginal Prolapse

Pelvic organ prolapse (POP) occurs when pelvic organs—such as the uterus, cervix, or vaginal walls—descend to or beyond the vaginal opening. It is a common condition affecting many women worldwide and can significantly impact quality of life, including sexual function. With an aging population and greater awareness, more women are reporting symptoms, and the prevalence of POP is expected to rise.

The most common symptom is the sensation of a “bulge” or something protruding from the vagina. Other symptoms can include backache, sexual difficulties, trouble passing urine, or challenges with bowel movements. Some women may need to apply gentle pressure to the perineum to assist with bowel emptying.

Treatment options include conservative management or surgery. Conservative approaches include pelvic floor exercises, local vaginal estrogen cream, and vaginal pessaries—silicone devices (commonly rings) inserted into the vagina to support prolapsed organs.

Surgical repair of pelvic organ prolapse can be performed vaginally, laparoscopically, or using a combination of both methods. The surgical approach is tailored to the type of prolapse and the woman’s individual needs. Importantly, women with prolapse do not always require a hysterectomy.

Urinary Incontinence

Urinary urgency and involuntary urine leakage are common in women but often under-reported. This condition can be distressing and affect daily life.

Urinary incontinence can be classified as stress incontinence, urge incontinence (overactive bladder), or mixed incontinence. Accurate diagnosis can be challenging, and urodynamic testing is often used to determine the exact cause and guide treatment.

Treatment options include conservative management or surgery. Conservative measures involve pelvic floor exercises, local vaginal estrogen therapy, and the use of vaginal pessaries.

Surgical options for stress urinary incontinence include vaginal procedures, such as retropubic tape or mid-urethral sling, and laparoscopic procedures, such as Burch colposuspension. While the mid-urethral sling uses mesh, the Burch colposuspension is a mesh-free alternative.