Many women may have symptoms of vaginal prolapse and stress urinary incontinence. Problems with urine control and changes in bowel habits are usually the two most common symptoms. Vaginal prolapse is a problem in which structures such as the uterus, bladder, urethra, small intestine, or the vagina itself begin to fall out of their normal positions. Without treatment, structures could collapse further.

Different types of vaginal prolapse.

Prolapse of the rectum or rectocele
A prolapse of the rectum affects the back wall of the vagina. When weakened, the rectal wall may press against the vaginal wall. This can cause a bulge and be felt during a bowel movement. This can be due to injuries during childbirth.

Bladder prolapse or cystocele
If the anterior vaginal wall protrudes, the bladder may fall into the vagina. The urethra can also prolapse, which is called the urethra. The condition of cystourethrozele is when the urethra and the bladder fall out. A typical symptom of this combination may be stress urinary incontinence, a leakage of urine that can occur when you cough, sneeze, or exercise.

Prolapse of the uterus
This can happen when a group of ligaments called the uterosacral weakens at the top of the vagina. Once these ligaments are weakened, the uterus can fall out. Vaginal arch prolapse can occur after a hysterectomy, in which the uterus is removed. The uterus supports the top of the vagina. This condition can occur after a hysterectomy. About 30-40% of women can develop vaginal prolapse in their lifetime. Prolapse can occur after menopause, childbirth, or hysterectomy. During childbirth, the supportive tissue surrounding the vagina may separate and weaken as the baby moves through the birth canal. The weakening could gradually worsen and later lead to the pelvic structures falling from their original position. “

For those going through menopause, estrogen could help keep muscles and tissue strong. As soon as the estrogen level drops, the supporting structures can weaken. For patients who have had a hysterectomy, the uterus may be important for the support structure at the top of the vagina. Without the uterus, the top of the vagina may fall out. Some other risk factors include advanced age, obesity, unusual stress on the support structures, and an unusual increase in abdominal pressure.

Many cosmetic gynecologists agree that the most reliable way to diagnose is through a physical exam and history. Each section of the vagina can be examined to determine the type and extent of prolapse and to determine the appropriate treatment.

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