What is a Vaginal Prolapse?
A vaginal prolapse (also known as a pelvic organ prolapse or genital prolapse) occurs when an organ located within the pelvis ‘drops’ from its normal position in the human body. A prolapse frequently occurs when the tissue of the pelvic floor (also known as fascia) is damaged.
Vaginal Prolapse: Risk Factors
You are at a higher risk of a vaginal prolapse if you:
- Have had multiple vaginal deliveries
- Have a history of instrumental delivery (forceps-assisted)
- Suffer from obesity
- Are prone to chronic coughing (typical of smokers or people with chronic bronchitis)
- Are prone to chronic constipation
- Frequently perform activities that necessitate heavy lifting & straining
- Have a hormone imbalance
- Have had a hysterectomy
- Are approaching menopause or are post-menopausal
Making the right lifestyle changes can reduce your likelihood of suffering from a vaginal prolapse or temper your symptoms if you already have the condition. Don’t worry if you don’t know what to do – when you consult Dr G, he’ll be able to tell you just what those lifestyle changes should be.
Vaginal Prolapse: Symptoms
The symptoms most commonly apparent in cases of pelvic organ prolapse include:
- Sensation of heaviness or pressure in the vagina
- Pain in the lower back and pelvic region
- Difficulty emptying bladder, urinary incontinence, or a frequent need to urinate
- Frequent UTIs (urinary tract infections)
- Enlarged vaginal opening
- Straining while having a bowel movement (this can also trigger a pelvic organ prolapse)
- Sensation of something protruding out of the vagina
- Pain during sexual intercourse
If you identify with any of the symptoms above, make an appointment with Dr G soon. With his knowledge, expertise, and experience, he’ll be able to trace the cause of your problems, diagnose your condition, and recommend the course of action most suited to your individual case.
Vaginal Prolapse: Types
A vaginal prolapse can manifest itself in a number of ways. These types include:
- Cystocele (prolapsed bladder): the bulging of the bladder into the vagina
- Urethrocele (urethral prolapse): the prolapse of the urethra (often accompanies a cystocele)
- Rectocele: the bulging of the rectum into the vagina
- Uterine prolapse (prolapsed uterus): the descending of the uterus into the vagina
- Enterocele: the protrusion of the intestine into the vagina
- Vaginal vault prolapse: the protrusion of the vaginal cuff (post hysterectomy) into the vagina
Vaginal Prolapse: Treatment Options
While a mild vaginal prolapse necessitates no surgical treatment and can even be resolved through special strengthening exercises and lifestyle changes, there are several instances where a prolapse can be a significant cause for concern. Dr G will be able to diagnose the severity of your case and discuss treatment options with you, should you need them. For best results, Dr G recommends a long-term solution that attends to all support problems simultaneously.
Non-Surgical Prolapse Treatment
Mild cases of vaginal prolapse can be treated through:
- Lifestyle modification (such as smoking cessation, weight loss, and allergy treatments)
- Pelvic floor exercises (such as Kegel exercises) to treat urinary incontinence
- Pessaries (devices inserted into the vagina) to provide affected organs with support
- Hormone replacement therapy
There are several different procedures available to correct a vaginal prolapse should surgical intervention be required. Dr G will discuss these options with you in detail at the time of your consultation. He will also recommend the procedure(s) most suited for your individual case based on your age, sexual function, medical fitness, and the nature and extent of your vaginal prolapse.
The prolapse surgery options available include:
- Native tissue repair: this prolapse surgery option involves using your own tissue (fascia) to strengthen the prolapsed site.
- Mesh augmentation: this procedure uses synthetic mesh to strengthen the prolapsed site. The mesh can be placed vaginally or abdominally using keyhole surgery (laparoscopy). While your vaginal prolapse is less likely to recur with mesh surgery, the procedure has been associated with complications like pain and mesh erosion. Dr G will provide you with more information about this prolapse treatment option during your appointment.
- Hysterectomy: this prolapse treatment involves the surgical removal of the uterus. It can be done either vaginally or via keyhole surgery. Dr G will be able to advise you about the best option after taking your age, medical fitness, and the severity of your vaginal prolapse into consideration.
- Uterine preservation: this prolapse surgery method uses synthetic tissue or special stitches to anchor the prolapsed uterus to a stronger support. This can be done vaginally or via keyhole surgery
- Vaginal obliteration: this method involves closing the vaginal cavity after addressing the prolapse. It is a very short procedure and is normally done as a day procedure or overnight, and under regional anaesthesia. It is ideal for elderly women who are not sexually active, who have not responded to more conservative vaginal prolapse treatment methods, and who are not suitable candidates for longer pelvic reconstructive surgery.
For more information on treating a vaginal prolapse surgically, visit our page Surgical Management of Vaginal Prolapse.