[Non surgical treatment of prolapse].

Surgery is the treatment of pelvic prolapses. But in case of stage 1 prolapses or surgical contra-indication, some non surgical treatment can be proposed. There is no scientific proof of efficacy of an hormonal treatment. Pessaries are an alternate with satisfaction for voluntary patients, it gives 58 to 80% satisfaction; in young patients or if surgery is contra-indicated, pessaries can be proposed; vaginal discomfort induced by pessaries can be improved by local oestrogenotherapy. Pelvic floor training has been compared in some studies with no training: after 2 years, 72% versus 27% without worsening of the prolapse (Piya-Anant); in moderate prolapse, training can be useful. Prevention includes careful delivery management, struggle against overweight, carriage of weight, chronic cough, etc.