Question: I love your column. My question is about fallen bladder, which I have. What do you think is the best treatment? Surgery or something else. I am an 88-year-old woman.

Dr. Hibberd's answer:
Mild cases of cystocele, or fallen bladder — those with few or no obvious symptoms — may require no treatment or simple self-care measures such as Kegel exercises to strengthen your pelvic floor muscles. A physical therapist that specializes in pelvic floor disorders may be helpful in teaching these exercises. A vaginal pessary is a plastic or rubber ring that's inserted in the vagina to support the bladder by pushing it up and back into place. If you have noticeable, uncomfortable symptoms, the cystocele may require surgery. In most cases, surgery consists of a vaginal repair. In this procedure, a surgeon elevates the prolapse back into place, removing redundant tissue and tightening the muscles and ligaments of your pelvic floor. While the benefits of this type of surgery can last for many years, there's some risk of recurrence.