Pelvic Floor Exercises (Kegel Exercise)
Pelvic floor exercises are often taught to patients for treatment of urinary incontinence as well as vaginal prolapse. Though Kegel may be an effective treatment for fecal and urinary incontinence it has not been "proven" to be effective for prolapse. As described above, prolapse occurs due to a break in the fascia support system. Exercising the pelvic floor muscles will not put these breaks back together nor will it pull the prolapsed vagina, bladder, urethra, rectum, or uterus back into position. A simple analogy: a patient with an umbilical (belly button) hernia has a break in the supportive abdominal wall fascia…..all the sit-ups in the world may strengthen the abdominal wall muscles but will never put the abdominal wall fascia back together. However pelvic floor exercises may be useful especially when used in conjunction with a pessary. Pelvic floor exercises will strengthen the muscles of pelvic floor, and may enhance the ability to retain the pessary in the vagina.
Pessary Therapy
A pessary is a small device that can be inserted into the vagina to support the prolapsed vagina and its neighboring organs. This may relieve symptoms and reduce the prolapse, thus avoiding surgery. Many different types of pessaries are available for prolapse and urinary incontinence, some of which are shown below.
Prolapse Treatment: Figure 1
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