Q: My mother (75 years old) is experiencing prolapse uterus for the last 2-3 months. The main problem is that she is unable to hold the natural calls even for a few minutes. She has other problems like hypertension (170/90) and osteoporosis. I would like to know the possible treatments? If at all she needs to remove the uterus is it safe at this age, and whether this can be done after 5-6 months?

A:It is not just the removal of the uterus but also the plastic surgery of the pelvic floor that cures the associated problems of prolapse uterus. Your mother is a high risk for surgery due to hypertension. The anaesthetist and cardiologist can check her for fitness for surgery. Also, the anaesthetist will assess whether or not she is fit for regional (epidural) anaesthesia, after examining her back etc. It is better she undergoes treatment earlier than later (if declared fit). Meantime she can use a vaginal pessary, which will temporarily relieve her of the prolapse symptoms, but not necessarily of the incontinence. Also, due to age related changes in the vagina, use of the pessary is not as easy and simple as it may sound. If use of the pessary is not possible, she can use a cotton tampon soaked in glycerine - acriflavine solution to reduce the prolapse. But the tampon will have to be changed twice a day - otherwise it will stink and cause more problems and generalised infection in the body. Best advice can be given only after personally examining the patient.