Vaginal prolapse

Vaginal prolapse is a medical condition characterized by the descent or drooping of the vagina and the structures surrounding it. This condition occurs when the pelvic floor muscles and ligaments that support the vagina weaken. Vaginal prolapse can affect women of any age but is more common in postmenopausal women who have had one or more vaginal deliveries.

Causes

The primary cause of vaginal prolapse is the weakening of the pelvic floor muscles and ligaments. Factors contributing to this weakening include:

• Childbirth: Vaginal delivery can stretch or tear the supporting tissues of the vagina.
• Menopause: Decreased estrogen levels can weaken the vaginal and pelvic tissues.
• Aging: Natural aging can reduce muscle tone in the pelvic floor.
• Heavy lifting or straining: Repeated heavy lifting or straining can put pressure on the pelvic organs.
• Obesity: Excess weight increases the strain on pelvic floor muscles.
• Chronic coughing: Persistent coughing can exert pressure on the pelvic organs.
• Genetics: Some women may have a genetic predisposition to weaker connective tissue.

Symptoms

Symptoms of vaginal prolapse can vary depending on the severity of the condition but may include:

• A feeling of heaviness or pulling in the pelvis
• Tissue protruding from the vagina, which may be felt or seen
• Urinary problems, such as incontinence or urinary frequency
• Bowel issues, such as constipation
• Sexual dysfunction
• Lower back pain

Types

Vaginal prolapse can be classified into several types, depending on the organ that is descending:

• Cystocele: Prolapse of the bladder into the vagina.
• Rectocele: Prolapse of the rectum into the vagina.
• Uterine prolapse: Descent of the uterus into the vagina.
• Enterocele: Herniation of the small intestine into the space between the vagina and rectum.
• Vaginal vault prolapse: Prolapse of the vaginal apex after hysterectomy.

Diagnosis

Diagnosis of vaginal prolapse typically involves a pelvic exam. During the exam, a healthcare provider will assess the strength of the pelvic floor muscles and the degree of prolapse. Additional tests, such as ultrasound or MRI, may be used to evaluate the extent of the prolapse and the involvement of other pelvic organs.

Treatment

Treatment options for vaginal prolapse depend on the severity of the condition and the patient's symptoms. Options include:

• Pelvic floor exercises: Strengthening the muscles of the pelvic floor can help support the pelvic organs.
• Pessary: A device inserted into the vagina to support the pelvic organs.
• Surgery: Surgical options vary depending on the type of prolapse and can include repair of the vaginal wall or supporting tissues, or hysterectomy in cases of uterine prolapse.
• Lifestyle changes: Weight loss, avoiding heavy lifting, and treating chronic coughing can alleviate symptoms.

Prevention

Preventive measures for vaginal prolapse focus on strengthening the pelvic floor muscles. Regular pelvic floor exercises, maintaining a healthy weight, and avoiding activities that strain the pelvic floor can help reduce the risk of prolapse.