Vaginal Prolapse

Prolapse is the slipping forward/down of a part of the body into the surrounding area. Due to weakening of the muscles that support the birth canal, there is a tendency for the walls to become lax and protrude into the canal.

The situation rarely involves the vagina alone. Often, the protrusion also involves part of the bowel (enterocele), bladder (cystocele) or rectum         (rectocele).

vaginal prolapse

Causes of Vaginal Prolapse

All of the following stretch and weaken the muscles of the hip and hence vagina looses its support, resulting in prolapse:

  • Multiple Births or giving birth to large children
  • Prolonged Labor
  • Chronic Constipation
  • Aging

 

Symptoms of Vaginal Prolapse

Vaginal Prolapse is associated with the following symptoms:

  • Heaviness and pulling sensation near vaginal opening
  • Backache
  • Difficulty with sexual intercourse.
  • Frequent urinary infections

However, please be aware that these symptoms are relieved when lying down.

In case of bladder or bowel involvement, one might notice additional symptoms like:

  • Uncontrolled, involuntary passing of urine when laughing, coughing or exercising can also be noted in case of urinary bladder involvement.
  • Difficulty with bowel movements is associated with rectocele.

Diagnosing Vaginal Prolapse

Routine gynecological examinations

Usually patients tend to hide symptoms of prolapse due to fear of embarrassment. So, this is usually noted during routine examinations.

Bladder function tests

The presence of bladder involvement needs to be confirmed. This can be done with the help of bladder function tests.

Treatments for Vaginal Prolapse

Non Surgical Treatments

Pessary insertion: Pessary is a small, usually round device which is inserted into the vagina and helps to hold the walls of the birth canal in place to an extent and this lessens the symptoms of prolapse. However, pessary insertion does not fix the problem. Moreover, long term use of pessaries may cause severe infections of the birth canal.

Physiotherapy: Vaginal Strengthening exercises may also help this condition. But provides only temporary relief from the symptoms.

Surgical Treatments

Surgical correction of the Prolapse is the only permanent solution for this problem.

Laparoscopic Vault suspension is the procedure of choice for Vaginal Prolapse. This is a minimally invasive procedure in which the weak vaginal muscles are pulled up and sutured to the unaffected strong muscles of the hip.

Prevention of Vaginal Prolapse

  • Avoid heavy weight lifting a specially after a surgery or childbirth, because the weak muscles at this time are vulnerable to slip from their original position, resulting in prolapse.
  • Stop smoking since smoking also weakens the muscles.
  • It has been noted that overweight women are more prone to develop vaginal prolapse easily. This is probably due to damage to muscles, resulting from strain over the pelvic musculature over a long period of time. Hence it is advised to maintain a healthy body weight.
  • Treat constipation by drinking enough water or with medications like stool softeners, to avoid straining.

LIMA Vault Suspension Specialists

Dr. Deepa Ganesh

Advance Laparoscopic Gynecologist, Robotic Surgeon & Cosmetic Gynecologist Surgeon

Dr. Jayalakshmi

Obstetrician and gynaecologist, Infertility specialist and Laparoscopic surgeon