Vaginal prolapse is a troubling, yet very common problem. Ligaments, connective tissue and muscles all provide support to the pelvic organs (bladder, uterus, small intestines, colon and rectum). Vaginal prolapse results when the supporting structures lose their strength due to childbirth, nerve damage or just with natural aging.
Many women describe vaginal prolapse in terms such as “their bladder is falling” or “their rectum is falling”. Doctors use medical terminology such as cystocele for bladder prolapse or rectocele for rectal prolapse. In some cases, an individual will have a surgical repair of their prolapse and then have it occur again. This is referred to as recurrent prolapse and is especially bothersome to women. If left untreated, prolapse may interfere with bowel, bladder and sexual functioning.
Who is at Risk for Vaginal Prolapse?
Vaginal prolapse most often occurs in women who have had more than one baby through normal vaginal delivery and in post-menopausal women. During menopause a woman’s ovaries stop producing the hormones that regulate her monthly menstrual cycle. Estrogen is one of the hormones that helps to keep the pelvic muscles strong, but as production declines it affects the overall strength of those muscles.
Some other common causes of vaginal prolapse include one or more pregnancies, vaginal births, giving birth to a large baby, frequent heavy lifting, chronic coughing and frequent straining during bowel movements.
Symptoms of Vaginal Prolapse
- A sensation of heaviness in the vagina
- A distinct lump or bulge in the vagina
- Tissue protruding out of the vagina
- Persistent aching in the lower back
- Trouble passing urine
- Frequent urinary tract infections
- Greater than normal amounts of vaginal discharge
- Painful sexual intercourse
Diagnosis and Treatment for Vaginal Prolapse
The diagnosis of vaginal prolapse is done through physical exam. The physician will examine you both laying back and standing up. Rarely, the physician may order a defecogram to help understand the nature of the prolapse.
Pelvic Floor Exercises - In mild to moderate cases, special muscle strengthening exercises of the pelvic floor can correct vaginal prolapse. The physicians and staff at the center will provide proper instruction and give you a better chance of performing the exercises correctly and with the necessary number of repetitions.
Vaginal Pessary – Pessaries are plastic devices that come in many different shapes and sizes. Once placed inside the vagina, the pessary holds the prolapsed vagina back into the pelvis. Pessaries are an excellent, long-term nonsurgical treatment option for women of all ages.
Surgical Procedures - In moderate to severe cases, the prolapse may have to be surgically repaired. Surgery is usually performed through the vagina or abdomen. Currently, there is little data or scientific evidence to support the use of laparoscopy in prolapse repairs. The route and type of surgery you undergo depend on many factors that your doctor will discuss thoroughly with you.