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Vaginal Prolapse

Vaginal prolapse occurs when an organ in the pelvis or the top portion of the vagina drops down into or pushes into the vaginal vault. This condition occurs when the muscles, ligaments and other structures surrounding the vagina are weakened or damaged. Vaginal prolapse is more common in women who have given birth, experienced menopause and/or have had a hysterectomy. There are five different types of prolapse. Cystoceles occur when the front of the vaginal wall weakens, allowing the bladder to herniate into the vagina. Enteroceles occur when the front and back vaginal walls separate, allowing the small bowel to press against or herniate into the vagina. Rectocele occurs when the back of the vaginal wall weakens and the rectum presses against or prolapses into the vagina. Uterine prolapse occurs when the ligaments that support the top of the vagina weaken, which may cause the front and back of the vaginal walls to weaken as well, resulting in the prolapse of the uterus. Vaginal vault prolapse occurs when the upper portion of the vagina drops toward the vaginal opening after the removal of the uterus.

Symptoms:

The symptoms of vaginal prolapse vary depending on which type of prolapse has occurred. The most common symptoms are:

  • A sensation that the organs are out of place
  • Pressure in the vagina or pelvis
  • Discomfort during sexual intercourse
  • Recurrent urinary tract infections

Risk Factors:

  • Strain during childbirth
  • Hysterectomy
  • Obesity
  • Long lasting cough
  • Anything that puts pressure on your abdomen

Evaluation & Diagnosis:

A thorough history and physical exam is performed to determine the cause of the prolapse. Sometimes tests such as Ultrasound of the Pelvic or a CT scan may be ordered as well. 

Treatment: 

The treatment for vaginal prolapse depends on the cause of the condition and the severity of the symptoms. The most common treatment options are: 

Kegel Exercise: uses a tightening and relaxing of the sphincter muscle to promote strengthening of the pelvic floor.

Vaginal Pessaries: uses a silicone or latex devices which is inserted into the vagina to compress the urethra and support the bladder neck.

Estrogen Replacement Therapy: uses hormones administered internally or externally to help improve the support structure of the pelvic area.

Surgery: uses a mesh-like material or slings to correct the position of the organ and to secure it in place.