What is a prolapse?
Prolapse is a descent of pelvic organ out of its normal anatomical position due to luck of its support. It may involve the uterus(womb) alone, the vagina alone, or both the uterus and the vagina.
Vaginal prolapse is very common. About 50% of women who have had children have some degree of pelvic organ prolapse.
Types of prolapse
There are four common types of prolapse: uterine prolapse, cystocele, rectocele and post hysterectomy vaginal vault prolapse.
- uterine prolapse occurs when the ligaments that supports the uterus have been torn or stretched, allowing the womb to move downwards.
- a cystocele is a bulge in the front wall of the vagina which allows the bladder to move downwards.
- a rectocele is a bulge in the back wall of the vagina which allows the back passage (rectum) to move downwards.
- vaginal vault prolapse occurs in women who have had a hysterectomy previously, the vault (top of the vagina) moving downwards.
Causes of prolapse
Prolapse occurs over a period of time and is usually caused by damage to the supporting muscles of the pelvic floor during childbirth.
Being overweight, heavy lifting, chronic constipation and a lack of hormones after the menopause can produce further weakening of these muscles, creating a prolapse.
Many women who develop symptoms of a vaginal prolapse do not seek medical help because of embarrassment or other reasons.
Symptoms of a prolapse
Some women with vaginal prolapse do not have any symptoms and the condition is only discovered during an internal examination for another reason.
The feeling of a bulge or lump at the entrance to the vagina is the most common symptom. Many women describe uncomfortable feeling of fullness, dragging or heaviness in the vagina. Most of these symptoms are worse when a woman has been on her feet for some time, especially with lifting and sport.
A prolapse can interfere with sexual intercourse, women often finding this uncomfortable. The increased vaginal size and lack of muscle tone may cause intercourse to result in decreased satisfaction for both the woman and her partner.
Women with vaginal prolapse of the uterus often have other pelvic floor problems such as fecal or urinary incontinence.
Most vaginal prolapses gradually worsen and can only be fully corrected with surgery. However, the type of treatment that is appropriate to treat a vaginal prolapse depends on factors such as the cause and severity of the prolapse and the woman's personal circumstances.