What is vaginal prolapse?
A prolapse occurs when an organ of the body droops down or slips out of its normal place. Vaginal vault prolapse: The top of the vagina droops down into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus). More than one-third of women in the U.S. have some sort of pelvic area prolapse. Almost 25% feel some symptoms from the condition. Up to 11% of women require surgery for prolapse at some point in their lifetime.
Causes of vaginal prolapse
The organs of the pelvis include the vagina, cervix, uterus, bladder, urethra, intestines and rectum. These organs are held in place by a group of muscles and other tissue. When this support system becomes stretched or torn, it allows pelvic organs to sag down, or prolapse. The most common causes of vaginal and uterine prolapse are as follows:
- Childbirth: Vaginal delivery raises the risk of prolapse more than a cesarean section. It is also thought that the more children a woman delivers, as well as the delivery of a large baby (more than nine pounds), will raise the risk of prolapse.
- Surgery, such as a hysterectomy, or radiation treatment in the pelvic area.
- Menopause: A woman’s ovaries stop producing hormones that regulate her monthly cycle. The hormone estrogen, which helps keep pelvic muscles strong, is in lower supply.
- Extreme physical activity or lifting of heavy objects.
- Any condition that puts pressure on the abdominal area, such as being overweight or an intense or long-lasting cough such as in smokers or people with asthma.
- Genetic or hereditary factors: One person’s pelvic support system may be naturally weaker than another’s.
Symptoms of vaginal prolapse
In many cases a woman will feel no symptoms from prolapse and will find out about it only during an exam. However, the most common symptoms of vaginal prolapse are:
- A feeling of heaviness or pain in the pelvic area. Often this feeling gets worse as the day goes on or gets worse after standing, lifting or coughing.
- Lower back pain.
- Organs slipping out of the vagina.
- Leakage of urine.
- Bladder infections.
- Difficulty having a bowel movement or needing to push organs back into place following a bowel movement.
- Problems with sexual intercourse
Diagnosis and treatment of vaginal prolapse
Often a physical exam is all that is needed to diagnose prolapse. If additional information is needed, a number of tests may be done that measure how well each of the pelvic organs is working. Treatment of prolapse is done in a variety of ways:
- Hysterectomy: Surgical removal of the uterus in cases of severe uterine prolapse.
- Uterine suspension: Putting the uterus back in its normal position, either by connecting support tissue to the lower part of the uterus
- Kegel exercises: Tightening and relaxing the muscles used to control the flow of urine in order to strengthen the muscles that support the pelvic organs.
- Taking the hormone estrogen: Helps prevent further weakening of pelvic support muscles but has a number of possible negative side effects.
- Mona Lisa laser treatment
Mona Lisa laser is an effective treatment to stimulate the natural regeneration of the vaginal tissue. It is a simple procedure with minimal discomfort, suitable for almost all women and has virtually no down time from normal activities. Many women experience an improvement after 1 treatment. However, a course of 3 treatments, six weeks apart is recommended. As time passes, top-up treatments may be useful at approximately 6-12 monthly intervals.
You can take some simple steps to limit stress on the pelvic support system, especially if you have given birth.
- Limit heavy lifting
- Avoid unnecessary straining to have bowel movements.
- Avoid smoking so that you have a lower risk of chronic cough.
- Maintain a normal body weight through careful diet and exercise