Vaginal Prolapse: Symptoms, Causes, Treatment

What are the symptoms of vaginal prolapse?

The symptoms of vaginal prolapse can vary depending on the type and severity of the prolapse. Common symptoms include:

• Feeling of Fullness or Pressure: A sensation of heaviness or pressure in the pelvic area.
• Bulging: A noticeable bulge or lump in the vagina or at the vaginal opening.
• Discomfort or Pain: Discomfort, aching, or pain in the pelvic region, which may worsen with prolonged standing or physical activity.
• Urinary Symptoms: Difficulty starting urination, frequent urination, urinary urgency, or incontinence (leakage of urine).
• Bowel Symptoms: Difficulty with bowel movements, constipation, or feeling like you cannot completely empty your bowels.
• Vaginal Discharge: Increased vaginal discharge or a change in the character of the discharge.
• Sexual Dysfunction: Pain during intercourse or a feeling of vaginal looseness.
• Back Pain: Lower back pain that may be related to the prolapse.
• Increased Symptoms with Activity: Symptoms that worsen with activities like lifting, coughing, or straining.

Vaginal prolapse occurs when the pelvic organs, such as the uterus, bladder, or rectum, descend into or through the vaginal wall due to weakened pelvic support tissues. If you experience these symptoms, it’s important to consult a healthcare provider for proper evaluation and management.

What are the causes of vaginal prolapse?

Vaginal prolapse occurs when the pelvic organs descend into or through the vaginal wall due to weakened support tissues. The causes of vaginal prolapse include:

• Childbirth: The most common cause, especially after a vaginal delivery, as the pelvic muscles and connective tissues can be stretched or damaged during labor.
• Aging: Decreased estrogen levels and weakening of pelvic support tissues with age can contribute to prolapse.
• Hormonal Changes: Reduced estrogen levels, particularly after menopause, can weaken pelvic tissues.
• Genetics: A family history of pelvic organ prolapse or connective tissue disorders may increase the risk.
• Obesity: Excess weight puts additional pressure on the pelvic floor, increasing the risk of prolapse.
• Chronic Constipation: Straining during bowel movements can weaken pelvic muscles and support structures.
• Heavy Lifting: Repeated heavy lifting or straining can contribute to pelvic floor weakening.
• Chronic Coughing: Conditions that cause persistent coughing, such as chronic bronchitis, can strain the pelvic floor.
• Previous Pelvic Surgery: Past surgeries, such as hysterectomy, can affect the support structures of the pelvic organs.
• Pelvic Floor Disorders: Conditions that weaken the pelvic floor, such as pelvic floor dysfunction, can increase the risk of prolapse.

Each of these factors can contribute to the weakening of the pelvic support structures, leading to various types of vaginal prolapse.

What is the treatment for vaginal prolapse?

The treatment for vaginal prolapse depends on the severity of the prolapse and the symptoms experienced. Options include:

Conservative Treatments:

• Pelvic Floor Exercises: Strengthening exercises, such as Kegel exercises, can help improve muscle tone and support.
• Pessary: A device inserted into the vagina to support the pelvic organs and keep them in place. It can be used temporarily or long-term.
• Lifestyle Modifications: Managing weight, avoiding heavy lifting, and treating chronic constipation to reduce pressure on the pelvic floor.

Medical Treatments:

• Hormone Therapy: Estrogen therapy may help strengthen pelvic tissues, especially if vaginal dryness or atrophy is contributing to the prolapse.

Surgical Treatments:

• Surgical Repair: Various surgical techniques can repair the weakened pelvic support structures. These include:
• Anterior Repair (Cystocele Repair): Repairs a prolapsed bladder.
• Posterior Repair (Rectocele Repair): Repairs a prolapsed rectum.
• Vaginal Vault Suspension: Supports the top of the vagina, particularly if the uterus has been removed.
• Sacrocolpopexy: A surgery that attaches the vaginal apex to the sacrum using a mesh or other material for support.

Additional Considerations:

• Patient Education: Understanding the condition and treatment options helps in managing symptoms and preventing recurrence.
• Follow-Up Care: Regular follow-up with a healthcare provider is important to monitor the condition and adjust treatment as needed.