Treatment options range from no treatment for a mild<unk>  to surgery for a more extensive<unk> . If a<unk>  is not bothersome, the clinician may only recommend avoiding heavy lifting or straining that could cause the<unk>  to worsen. If symptoms are moderately bothersome, the doctor may recommend a pessary, a device placed in the vagina to hold the bladder in place and to block protrusion. Treatment can consist of a combination of non-surgical and surgical management. Treatment choice is also related to age, desire to have children, severity of impairment, desire to continue sexual intercourse and other diseases that a woman may have. Non-surgical<unk>  is often treated by non-surgical means: * Pessary – This is a removable device inserted into the vagina to support the anterior vaginal wall. Pessaries come in many different shapes and sizes. There are sometimes complications with the use of a pessary. * Pelvic floor muscle therapy – Pelvic floor exercises to strengthen vaginal support can be of benefit. Specialized physical therapy can be prescribed to help strengthen the pelvic floor muscles. * Dietary changes – Ingesting high fiber foods will aid in promoting bowel movements. * Estrogen – intravaginal administration helps to prevent pelvic muscle atrophy Surgery The surgery to repair the anterior vaginal wall may be combined with other procedures that will repair the other points of pelvic organ support such as anterior-posterior repair and anterior colporrhaphy. Treatment of<unk>  often accompanies the more invasive hysterectomy. Since the failure rate in<unk>  repair remains high, additional surgery may be needed. Women who have surgery to repair a<unk>  have a 17% of needing another operation within the next ten years. The surgical treatment of<unk>  will depend on the cause of the defect and whether it occurs at the top (apex), middle, or lower part of the anterior vaginal wall. The type of surgery will also depend on the type of damage that exists between supporting structures and the vaginal wall. One of the most common surgical repairs is colporrhaphy. This surgical procedure consists of making a longitudinal folding of the vaginal tissue, suturing it into place and creating a stronger point of resistance to the intruding bladder wall. Surgical mesh is sometimes used to strengthen the anterior vaginal wall. It has a 10–50% failure rate. In some cases a surgeon may choose to use surgical mesh to strengthen the repair. During surgery, the repair of the vaginal wall consists of folding over and then suturing the existing tissue between the vagina and bladder to strengthen it. This tightens the layers of tissue to promote the replacement of the pelvic organs into their normal place. The surgery also provides more support for the bladder. This surgery is done by a surgeon specializing in gynecology and is performed in a hospital. Anesthesia varies according to the needs of each woman. Recovery may take four to six weeks. Other surgical treatment may be performed to treat<unk> . Support for the vaginal wall is accomplished with the paravaginal defect repair. This is a surgery, usually laproscopic, that is done to the ligaments and fascia through the abdomen. The lateral ligaments and supportive structures are repaired, sometimes shortened to provide additional support to the vaginal wall. Sacrocolpopexy is a procedure that stabilizes the vaginal vault (the uppermost portion of the vagina) and is often chosen as the treatment for<unk> , especially if previous surgeries were not successful. The procedure consists of attaching the vaginal vault to the sacrum. It has a success rate of 90%. Some women choose not to have surgery to close the vagina. This surgery, called colpocleisis, treats<unk>  by closing the vaginal opening. This can be an option for women who no longer want to have vaginal intercourse. If an enterocele/sigmoidocele, or prolapse of the rectum/colon, is also present, the surgical treatment will take this concurrent condition into account while planning and performing the repairs. Estrogen that is administered vaginally before surgical repair can strengthen the vaginal tissue providing a more successful outcome when mesh or sutures are used for the repair. Vaginal thickness increases after estrogen therapy. Another review on the surgical management of<unk>  describes a more successful treatment that more strongly attaches the ligaments and fascia to the vagina to lift and stabilize it. Post surgical complications can develop. The complications following surgical treatment of<unk>  are: * side effects or reactions to anesthesia * bleeding * infection * painful intercourse * Urinary incontinence * constipation * bladder injuries * urethral injuries * urinary tract infection. * vaginal erosion due to mesh After surgery, a woman is instructed to restrict her activities and monitor herself for signs of infection such as an elevated temperature, discharge with a foul odor and consistent pain. Clinicians may recommend that sneezing, coughing, and constipation are to be avoided. Splinting the abdomen while coughing provides support to an incised area and decreases pain on coughing. This is accomplished by applying gentle pressure to the surgical site for bracing during a cough. Recurrent surgery on the pelvic organs may not be due to a failure of the surgery to correct the<unk> . Subsequent surgeries can be directly or indirectly relating to the primary surgery. Prolapse can occur at a different site in the vagina. Further surgery after the initial repair can be to treat complications of mesh displacement, pain, or bleeding. Further surgery may be needed to treat incontinence. One goal of surgical treatment is to restore the vagina and other pelvic organs to their anatomically normal positions. This may not be the outcome that is most important to the woman being treated who may only want relief of symptoms and an improvement in her quality of life. The International Urogynecological Association (IUGA) has recommended that the data collected regarding the success of<unk>  and pelvic organ repairs include the presence or absence of symptoms, satisfaction and Quality of Life. Other measures of a successful outcome should include perioperative data, such as operative time and hospital stay. Standardized Healthcare Quality of Life should be part of the measure of a successful resolution of<unk> . Data regarding short- and long-term complications is included in the recommendations of the IUGA to better assess the risk–benefit ratio of each procedure. Current investigations into the superiority of using biological grafting versus native tissue or surgical mesh indicates that using grafts provides better results.
Cystocele
Nabothian cyst
Pseudomeningocele
Bartholin's cyst
Dacryocystocele
Urethral diverticulum
Ureterocele
Lymphocele