A vaginal prolapse refers to an outward bulging of the vagina. It is also referred to as a vaginal prolapse and medically represents a fourth-degree vaginal prolapse.
What is a vaginal prolapse?
A vaginal prolapse is the outward bulging of the vagina. There is at least a more or less visible protrusion of the vaginal mucosa. This leakage can be seen in the genital area of the woman. The vagina protrudes from the body and thus occurs between the labia. See deluxesurveillance for Leukocytosis Guide.
Furthermore, the vaginal prolapse can be enlarged by the emergence of other organs. These organs then occupy the space previously occupied by the vagina. Whether this happens depends, among other things, on which part of the vagina is exiting. For example, the cervix (rarely the uterus), the urethra and the bladder can also be affected. More rarely, the posterior vaginal wall also protrudes, which can lead to rectal involvement.
The vaginal prolapse can be further subdivided, whereby the extent must be determined. Complete vaginal prolapse is referred to as prolapsus vaginae completus sive totalis, involvement of the cervix as prolapsus vaginae et cervicis. Partial forms in which the lowering of the internal female genital organs does not lead to a highly visible prolapse are also referred to as prolapsus vaginae incompleteus sive partialis.
The distinction between a vaginal prolapse and a vaginal prolapse is relevant for the definition: a vaginal prolapse means a change in the localization of the internal organs, while a vaginal prolapse explicitly means the exit. There are four degrees of vaginal prolapse and vaginal prolapse represents a fourth-degree vaginal prolapse. The other three degrees do not result in the organs protruding.
Bladder involvement in this context is referred to as a cystocele, urethral involvement as a urethrocystocele, and bowel involvement as a rectocele. This is usually linked to the degree of vaginal prolapse. If the lower third is affected, a urethrocystocele almost inevitably occurs. In two thirds, the cystocele follows and if the posterior vaginal wall has become detached, a rectocele can occur. The corresponding organs then enter the unused space and sometimes additionally displace the components of the vagina.
The causes of a vaginal prolapse are based on the holding apparatus of the vagina and the stresses that a woman experiences. The musculoskeletal system itself, which consists largely of ligaments and muscles, is stressed over the years. Every birth presents a special challenge, especially in the case of large children and multiple births. Similarly, a vagina rarely fully recovers from a birth, but is still functional.
Rarely is a single birth the cause of a vaginal prolapse. Rather, vaginal births – depending on the health, age and physique of the woman giving birth – can turn out very differently. There are some injuries to the vagina itself and to the holding apparatus due to overstretching. The so-called maternal ligaments are particularly stressed during childbirth.
Menopause and aging also play a role. The holding apparatus loses elasticity due to aging and can promote changes in the position of the internal organs. Almost every woman after menopause also has a slight vaginal prolapse. This is to be considered normal.
Lifestyle has a strong role to play in the health of vaginal structures. Overweight, for example, has a counterproductive effect due to the constantly increased pressure. The same applies to chronic constipation and frequent, severe coughing. Improper lifting of heavy loads is also a risk factor for the occurrence of prolapses of all kinds.
Removal of the uterus (hysterectomy) can also lead to a vaginal prolapse if the resulting vaginal blind sac is not adequately secured. It can find its way down due to gravity and exit. Overall, it often happens that the vaginal prolapse develops gradually and the leakage of the vagina is triggered by a single event and thus becomes visible.
Symptoms, Ailments & Signs
Signs of an approaching vaginal prolapse are sometimes difficult to identify, since freedom from symptoms is the norm until the actual prolapse occurs. However, changes in the vagina can sometimes be detected by visual inspections.
The prolapse itself causes few symptoms. There may be a foreign body sensation in the vagina. Most women experience a feeling of pressure or tension that seems to be going down. There is also back pain, which can worsen over the course of the day. However, severe pain is rare in this context. The vaginal prolapse is also visible, at the latest after a slight spreading of the labia.
In addition, if the bladder and rectum are involved, there are also corresponding symptoms in this area. A urethrocele with cystocele can cause incontinence, a widespread cystocele can cause urinary retention, and a rectocele can interfere with defecation.
The complications associated with a vaginal prolapse arise primarily from the organs involved. Sometimes it is no longer possible to reverse the vaginal prolapse without surgical measures. This carries the usual risks of surgery. In this context, the uterus is often removed, which prevents natural fertility.
Any urinary retention that may occur can also be dangerous. After a certain time, this can affect the kidneys, which can ultimately lead to life-threatening sepsis if the bladder is not relieved.
When should you go to the doctor?
A prolapsed vagina will usually move affected women to the doctor quickly. The strong change in the sex organs is noticeable and visible.
In addition, a vaginal prolapse cannot usually be easily corrected manually by the person concerned. Going to the gynecologist is advisable here. If urinary retention has occurred, an emergency room should also be visited so that the bladder can be relieved quickly and the kidneys are not affected.
Overall, every vaginal prolapse is worth examining and requiring treatment. While such a prolapsed vagina occasionally occurs in some animal species and reverses itself, this is rarely the case in humans.
The diagnosis is made primarily by an external examination of the vagina. The doctor can quickly determine whether it is a whole vaginal prolapse or a stubborn vaginal prolapse. The vaginal prolapse is easier to recognize. Once the diagnosis has been made in this regard, the lower abdomen is also checked (e.g. using ultrasound) to check for possible displacement of other organs.
Part of the diagnosis is also an anamnesis, in which the patient and doctor work through moments that could have led to the prolapse. This is relevant to pinpointing the exact cause of the vaginal prolapse. This results in specific instructions for action for aftercare after treatment.
Treatment & Therapy
The treatment of a vaginal prolapse consists of acute treatment and follow-up care. The acute treatment aims to restore the vagina to its original condition. Surgical and non-surgical procedures can be considered. The non-surgical procedure essentially consists of using pessaries. These objects are inserted into the vagina and are primarily used to support the uterus. They are therefore mainly used when the uterus has come out through the vagina.
A pessary can be made of different materials and have very different shapes. It is intended for long-term use. Otherwise, there are also surgical procedures to be mentioned, all of which are considered to be uncomplicated.
The vagina can be tightened (on the front or back wall), often with the cervix being surgically altered or removed. This procedure is often used for a common vaginal prolapse. If all or part of the uterus is also involved, a hysterectomy is preferable.
If organs have entered the resulting space as a result of the incident, they will be repositioned manually. Sometimes it is necessary to fix the organs, which is often done via small incisions through the abdominal wall. The aftercare essentially consists of training the pelvic floor muscles and avoiding certain activities.
Outlook & Forecast
The prognosis for a vaginal prolapse is considered favorable. Almost all incidents of this type can be satisfactorily resolved operationally. Sometimes the insertion of a pessary is sufficient. The women who have experienced a vaginal prolapse do not have to fear any limitations in terms of sensations in the genital area.
Vaginal prolapse also has no effect on births and pregnancies unless the uterus is removed. However, it should be noted that a woman can experience more than one prolapse. This is very dependent on the integrity of their internal support system.
The vaginal prolapse can be prevented indirectly. The measures listed here serve to keep the vagina and the structures that support it healthy. It makes sense to do certain things simply not at all or rarely. For example, when lifting heavy loads, you should not lift from your back, but from your knees. This lifting technique results in a straight back, which means less pressure on the vagina.
Endurance sports, such as swimming or cycling, generally help to strengthen the inner and outer muscles. However, pelvic floor muscle training is the best preventive measure. Here the holding behavior and the feeling of tension in the vaginal area can be specifically influenced. Not only does it increase mindfulness and self-control, it also strengthens the vagina’s holding apparatus.
The pelvic floor muscle training is a preventive measure as well as a measure for aftercare. Overweight should also be reduced. Anyone who has also already experienced a vaginal prolapse should avoid excessive training of the abdominal muscles. Under unfavorable circumstances, this can increase the pressure on the vagina.
After the operation, it is advisable for the patient to avoid lifting heavy loads. It is also advisable to strengthen the pelvic floor muscles through continuous pelvic floor training. This has a targeted effect on the holding behavior and the tension in the area of the vagina. The correct learning of the pelvic floor training should ideally take place under the guidance of a physiotherapist and be practiced daily.
It is therefore both a preventive measure and an aftercare measure. Regular exercise, such as cycling or swimming, is helpful to improve general physical fitness and prevent another vaginal prolapse. However, you should avoid overtraining the abdominal muscles, as this may increase the pressure on the vagina.
Since severe obesity, chronic constipation and chronic cough also pose risks, these factors should be counteracted as part of the aftercare. A successfully treated vaginal prolapse usually has no further health consequences. Unless the uterus has been removed, it has no effect on further pregnancies and births.
Sex life is also normally not restricted after the healing phase is complete. However, lack of follow-up care increases the risk of suffering another vaginal prolapse.
You can do that yourself
In the event of a vaginal prolapse, there are hardly any self-help options that can cause a change in the optical conditions. Close cooperation with a doctor is therefore necessary for this disorder.
Various techniques can be used to manage the condition, providing an improvement in general well-being. Targeted training of the muscles in the pelvic floor area can help to tighten the muscles and thus alleviate the symptoms. The abdominal wall is strengthened by certain regular training sessions and improves the health of those affected. The exercises can be learned and carried out independently or together in a physiotherapeutic treatment.
If an operation is carried out, sufficient protection should take place. A balanced diet is also recommended for optimal wound healing. Sexual practices must be tailored to the needs of the organism. However, a complete renunciation of physical proximity is not advisable, since these studies generally support well-being and quality of life.
To avoid complications and side effects, non-prescribed medication to relieve pain should be avoided. Cognitive training can help to cope with the pain as well as the use of various natural remedies. Adequate heat supply to the abdomen provides many of those affected with a reduction in the symptoms that have arisen.