Vaginal Prolapse – Symptoms, Causes, Diagnosis & Treatment

As we have mentioned in our earlier articles, prolapse is a condition when the soft organs in the pelvis region ‘fall off’ their original place due to the weakening of muscles and tissues that support and hold them in their position.  The weakening of the supporting muscles can be due to various reasons that we will come across as we mention the causes of vaginal prolapse in the article. Vagina prolapse is no different from prolapse of other organs.

There are 3 different types of prolapse:

1. Anterior Vaginal Prolapse, also called Cystocele or Urethrocele. This happens when the bladder falls down through the vagina.
2. Posterior Vaginal Prolapse (Rectocele). This is a condition when the rectum bulges into the vagina. A wall of muscles exists between the vagina and rectum. When these muscles weaken, rectum pushes itself into the vagina causing Rectocele.
3. Apical Prolapse (Vaginal Vault Prolapse) – A condition when the cervix or the upper part of the vagina falls down into the vagina.

What are the symptoms of Vaginal Prolapse?

Depending on what type of prolapse you have, your symptoms may vary including:

1. Feeling of fullness in the pelvis region or in the vagina.
2. Vaginal prolapse can cause pain in abdomen and pelvic region. You may feel relaxed when you lie down.
3. Problems urinating or when passing stools
4. Frequent bladder infections
5. Abnormal Vaginal Bleeding.
6. Urine leakage (Incontinence) when you sneeze, cough or life heavy weights.
7. Pain during sex.

Causes of vaginal prolapse

In simple terms, weakening of muscles in the pelvis region cause prolapse of organs in the region. Following are the commonly seen factors that cause pelvis muscle weakening:

1. Pregnancy
2. Vaginal Child birth. If the vaginal birth was a traumatic one or a difficult one where the baby was large or took longer than usual time to come out, there is a higher probability of pelvic muscles to tear more.  Multiple child births worsen the condition.
3. Lifting of weights by putting pressure on the abdomen area instead of on the legs.
4. Being obese or overweight also puts pressure in the pelvis region.
5. Chronic (long term) constipation.
6. Lower levels of estrogen and menopause also contribute to weakening of pelvic muscles.
7. Age is also an important factor.

Who are at higher risk of having a vaginal prolapse?

Women who:

1. Vaginal delivery or multiple vaginal deliveries
2. A have drop in hormone levels
3. Smoke
4. Are overweight or obese
5. Have chronic constipation
6. life heavy weight regularly (at work or as a part of workout) in wrong ways
7. have fibroids

are at increased risk of damaging their pelvic muscles that can lead to vaginal prolapse or any other kind of prolapse.

Diagnosis of vaginal prolapse

Diagnosis of vaginal prolapse starts with a physical examination of the pelvis region. You may be asked to sit or lie down in different positions to test the strength of your muscles. If you have problems urinating, tests to determine bladder functioning such as uroflowmetry or cystometrogram are performed.

Pelvic ultrasound, MRI or a CT Scan may be required by your doctor to see exactly where the organ has prolapsed to.

Treatment options for Vaginal Prolapse

Treatment options for vaginal prolapse include surgical and non surgical methods.

Non surgical treatment methods to treat vaginal prolapse:

1. Kegel Exercise – This is the most commonly suggested exercise. Doing kegel’s exercise regularly for up to 3 months can strengthen the pelvis muscles and treat incontinence and also stop organs from prolapsing.
2. If you are obese or overweight, please workout and drop your weight to normal levels. It is not vaginal prolapse or other kinds of prolapse, losing weight and maintaining healthy BMI and waist size prevents you from suffering from a handful of other problems.
3. Usage of pessary. Pessary is a device made from rubber or plastic that is inserted into the vagina to hold the bulging tissues. Once you get used to inserting and taking out the pessary, you will find it easy to use.

Surgical treatment options for vaginal prolapse:

If your gynecologist determines that non surgical options may not work for you or if you have tried but in vain, you will be left only with surgical option. The aim of the surgery is to strengthen the muscles by using your own tissue or that from a suitable donor or a plastic/special material will be used to hold the organ in it’s place.  This vaginal prolapse correction surgery can be done either through the vagina or by using a laparoscope, depending on the patient’s condition, says Dr. Deepa Ganesh, one of the top notch gynecologists in Chennai.

How do you prevent vaginal or pelvic organ prolapse?

Strengthening the pelvic muscles is the ultimate solution to avoid pelvic organ or vaginal prolapse. If you have been working out before delivery, you must continue working out focusing more on the pelvis region.  If you were not exercising regularly before delivery, you must start working out as soon as you can after delivery.

Overweight and obese persons must make sure that they lose their excess fat and keep themselves fit. The problem of dip in hormone levels and menopause as the body ages can’t be avoided. Talk to your gynecologist on how to avoid prolapse as you age.