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The folds in the front and / or back walls of the vagina are tightened up and replaced to the correct position. This is done under a general anaesthetic and usually takes around one hour.
A prolapse of the vaginal walls occurs for a combination of reasons usually the strength of the connective tissue or collagen in the vaginal wall reduces with increasing age and with a reduction in hormones, usually from the age of 35 onwards. Gravity pulls the vaginal walls downwards and unless the pelvic floor strength is maintained with very active exercises, the condition will worsen. This is especially the case if a woman has to lift or carry a lot such as with small children, shopping or has a heavy lifting job. Finally, prolonged second stage of labour or delivery of large babies can lead to an increased risk of having a prolapse later on in life as the tissues have been distended and once elasticity is lost in the peri and post menopause, the walls sag down.
Many women find that the symptoms of dragging and discomfort improve with pelvic floor exercises alone and this may be helped by consulting with a specialist physiotherapist. If the vaginal skin and the pelvic floor muscles are weakening due to hormones, then the use of local oestrogens such as pessaries, cream or rings may improve the strength of the collagen and improve the ability of the tissues to respond to the exercises that you are doing.
However, if the prolapse is severe then usually these measures will only take the edge off the worse symptoms or you may not respond at all. However, it is a very good idea to still exercise and use a local oestrogen if appropriate both before surgery and especially after surgery to avoid the need for repeated surgery in the future.