Susan
What is Vaginal Prolapse?
Whether you are experiencing symptoms or you are simply interested in learning more about vaginal prolapse, read on to find out what it is, how it develops, and what treatment options are available.
Symptoms
Symptoms of vaginal prolapse can range from mild to severe. Depending on the degree of the prolapse, surgical and non-surgical treatments may be available. OB-GYNs can recommend a treatment plan for women.
Generally, a gynecologist will examine each part of the vagina individually. This includes the sphincter muscles, urethra, bladder, cervix, and vaginal walls. They will also test the strength of these muscles. They may also order a pelvic ultrasound.
If the prolapse is mild, the symptoms can be controlled through self-care. This may include activity modification. For example, avoiding strenuous exercise or lifting heavy objects. Other steps that can help reduce the risk of prolapse are maintaining a healthy weight and eating a balanced diet.
In severe cases, surgery is an effective way to treat vaginal prolapse. Other options for treating a prolapse include vaginal pessaries, kegel exercises, and hormone treatments. The amount of medical care needed depends on the type of prolapse, the woman’s age, and her medical condition.
Some of the signs of vaginal prolapse are painful intercourse, urinary incontinence, and urinary tract infections. These symptoms are more likely to occur after childbirth. A trigger event such as coughing or lifting a heavy object can worsen the situation. A midwife can be helpful in encouraging women to seek treatment.
Other complications of vaginal prolapse include the formation of sores and infection. The best way to prevent these problems is to seek medical attention at an early stage.
The most common symptom of vaginal prolapse is discomfort. This is usually a mild discomfort, but may be more noticeable during sexual intercourse. It can also be felt when peeing, and sometimes after standing or coughing.
Besides the pain, other symptoms of vaginal prolapse include fullness and the feeling that something is falling out. Some women experience no symptoms at all. However, if symptoms become more severe, it’s important to see a doctor. The gynecologist will determine the type of prolapse and recommend the appropriate treatment.
Symptoms of vaginal prolapse may also be accompanied by other problems, such as recurrent urinary tract infections and difficulty emptying the bladder. If these problems are serious, your gynecologist may recommend surgery to treat the condition.
Causes
Several conditions can cause vaginal prolapse, including obesity, childbirth, or a chronic cough. However, this condition is not always serious and can be treated without surgery. It can be diagnosed by your healthcare provider with a physical exam.
Vaginal prolapse is a condition in which the tissues around the vagina droop or become weakened, causing the organs to prolapse or move out of position. Some women are at risk for developing this condition, especially if they’ve had multiple vaginal deliveries or have a history of hysterectomy. The symptoms can be painful and can affect the woman’s quality of life.
Some causes of vaginal prolapse include genetics, age, and pregnancy. It can also occur as a result of lifting heavy objects, a loss of estrogen, or a chronic cough. Surgical treatment can repair or strengthen pelvic muscles, which can help prevent further prolapse.
Some mild cases of prolapse can be corrected by making lifestyle changes or performing pelvic floor exercises. In more severe cases, surgery may be necessary. Depending on the type of prolapse, your healthcare provider will make a recommendation.
During an examination, your healthcare provider will ask you about your symptoms. These include pain in the pelvic region, difficulty emptying your bladder, or feeling that something is out of place.
If you have a pelvic prolapse, your healthcare provider can recommend treatments. Some of these include Kegel exercises, pelvic floor physical therapy, and hormone treatments.
If you have a severe prolapse, your OB-GYN can recommend surgery. This surgery may be performed through a small incision in the abdomen or through the vagina. The type of surgery will depend on the severity of the prolapse and the patient’s health.
The recovery period after surgery will vary, but most patients are able to return to normal activities within a couple of weeks. After that, patients need to keep up with regular follow-up visits with their OB-GYN.
Other treatments include pessaries, which are small devices inserted in the vagina. Pessaries are used for short-term support. They are also useful for childbirth-related prolapse. They should be removed on a regular basis to avoid infection.
Treatment options
Depending on the severity and type of prolapse, there are a number of treatment options. Nonsurgical treatments, such as pelvic floor exercises, may be able to provide relief to some women. If surgery is necessary, it is typically minimally invasive. It is also possible to have a vaginal pessary inserted for short-term support.
During a routine gynecological examination, a doctor can determine if a woman has a pelvic organ prolapse. He or she will examine each section of the vagina. If a prolapsed organ is present, a lump or bulge may be visible. During atypical physical exertion, such as sneezing or standing up, this bulge is most noticeable.
Pelvic organ prolapse is usually caused by the weakening of the muscles and ligaments in the pelvic floor. These muscles are used to support the vaginal organs. A decrease in estrogen in a woman’s body can also contribute to weakened muscles and ligaments. A decrease in estrogen may also lead to the breakdown of the connective tissue in the genital tract.
When a pelvic organ prolapse is severe, it can interfere with the function of the bladder and urethra. These functional disorders can affect a person’s quality of life.
Surgical treatments can help restore the proper function of the pelvic organs. These surgeries can be performed through a laparoscopic or abdominal approach. These methods are less invasive and can reduce recovery time.
Colposuspension is a surgical procedure that aims to attach the vaginal wall to the pelvic ligament. This surgery requires general anesthesia. The urethra is also examined during this procedure. The surgeon may recommend cystourethroscopy, which is a procedure in which a tube is inserted into the urethra to look inside.
Some women find that tampons can be a suitable form of temporary relief. However, they cannot change a grade three prolapse into a grade one.
Surgical treatments can also be used to correct more serious forms of prolapse. A procedure called abdominal sacral colopexy, for example, uses graft material to strengthen the vaginal walls. This method is only done when a woman has a severe form of prolapse.
OPTIMAL randomized clinical trial
OPTIMAL is a randomized clinical trial designed to assess the effect of pelvic muscle training (BPMT) on the symptoms and complications of apical vaginal prolapse. It is an initiative of the National Institute of Child Health and Human Development. It is a multicenter 2 x 2 factorial design. It involved 65 surgeons at 35 sites in the UK.
The OPTIMAL trial evaluated two common apical transvaginal prolapse repair procedures: sacrospinous ligament fixation surgery (SLSF) and uterosacral ligament suspension surgery (ULS). These operations involve attaching the top of the vagina to the pelvic ligaments. However, current evidence suggests that a few women may have anatomic recurrences after surgical intervention.
The primary and secondary outcomes of the OPTIMAL trial were symptom scores, anatomic success, and satisfaction with the operative procedure. These outcomes were assessed 24 months after surgery. Surgical success was measured by the percentage of women who had no apical descent greater than one-third into the vaginal canal.
The OPTIMAL trial found no significant difference between the BPMT and ULS groups in terms of apical descent rates or urinary symptoms at 6 months after surgery. However, both groups had a high rate of adverse events during the 2-year postoperative evaluation period. The BPMT group experienced fewer surgical adverse events than the ULS group.
The OPTIMAL study also found that both operations were equally effective in relieving prolapse symptoms. This was particularly true for the anterior compartment. The OPTIMAL findings are important for preoperative decision-making.
A subgroup analysis looked at the influence of age, prolapse type, and prolapse stage. Overall, the anterior and posterior compartments had 81 percent and 87 percent success rates, respectively. The BPMT and surgical groups were largely balanced, but the BPMT group had a higher rate of apical descent.
Although the OPTIMAL trial does not provide conclusive evidence for the role of perioperative BPMT in reducing urinary symptoms, it provides a sound basis for individualized physical incontinence therapy for women with new pelvic floor symptoms. The results are also helpful for assessing the role of perioperative BPMT for women undergoing surgery for stress urinary incontinence.
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U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
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Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
