The vagina is a muscular, tube-shaped organ running from the cervix of the uterus (the womb) down to an external opening at the vulva. The vagina is also a very elastic, distensible organ that forms the birth canal through which babies are delivered from the uterus.
A network of muscles and ligaments around the vagina help hold the vagina in its place as well as the other pelvic organs the surround the vagina. When those muscles and ligaments are weak or damaged, the pelvic organs can begin to fall out of place or “prolapse” into the vagina.
There are four types of prolapse, depending on the organs affected:
Causes of a prolapsed uterine and vagina
- Cystocele: A bulging of the upper front vaginal wall where a part of bladder bulges into the vagina, which may lead to urinary frequency, urgency, retention, and incontinence.
- Enterocele: The bulging ofthe upper vaginal wall where a portion of the abdominal wall bulges into the vagina. Standing leads to a pulling sensation and backache and is relieved when lying down.
- Rectocele: The bulging ofthe lower rear vaginal wall where the rectum bulges into the vagina. This makes bowel movements difficult to the point that the woman may need to push on the inside of the vagina to empty the bowel.
- Vaginal vault prolapse: The uterus dropping down into the vagina, or if the patient has had a hysterectomy, the top of the vagina itself falls downward.
Symptoms of a prolapsed uterine and vagina
- Pregnancy/multiple childbirths with normal delivery through the vagina
- Weakness in the pelvic muscles with advancing age
- Weakening and loss of tissue tone after menopause and loss of natural oestrogen
- Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumours (rare), or an accumulation of fluid in the abdomen
- Being overweight and its additional strain on pelvic muscles
- Radical surgery in the pelvic area leading to loss of external support
- Excess weight lifting
Women who have a minor uterine and vaginal prolapse may not have any symptoms. Moderate to severe prolapse may cause symptoms such as:
- Feeling like you are sitting on a ball
- Vaginal bleeding or increased discharge
- Problems with sexual intercourse
- Seeing the uterus or cervix coming out from the vagina
- Pulling or heavy feeling in pelvis
- Recurrent bladder infections
If you do develop uterine and vaginal prolapse that causes symptoms, it is important to see your doctor and get treatment right away. Without proper attention, the condition can cause impairment in bowel, bladder, and sexual function.
How uterine and vaginal prolapse is treated?
Treatment is not always necessary for this condition. If prolapse is severe, talk with gynaecologist about which treatment option is appropriate for you.
Nonsurgical treatments include:
- Weight loss (to take stress off of pelvic structures)
- Avoiding heavy lifting
- Kegel exercises (pelvic floor exercises that help strengthen the vaginal muscles)
- Oestrogen replacement therapy
- Pessary (a device inserted into the vagina that fits under the cervix and helps push up and stabilize the uterus and cervix)
Surgical treatments include:
- Hysterectomy (the uterus is removed from the body, either through the abdomen or through the vagina)
- Uterine suspension (the uterus is placed back into its original position by reattaching pelvic ligaments or using surgical materials)
Surgery is often effective, but it is not recommended for women who plan on having children in the future. Pregnancy and childbirth can put an immense strain on pelvic muscles, which can undo surgical repairs to the uterus