Vaginal prolapse

What is vaginal prolapse?

Vaginal prolapse is a common female condition where one or more of the pelvic organs (bladder, uterus, rectum or intestines) loses its support and drops into the vagina. A prolapse is a form of hernia and in more advanced cases, the prolapsed organ can visibly protrude from the vagina. 

What are the different kinds of prolapse?

  • Cystocele — occurs when your bladder prolapses into the front of your vagina
  • Rectocele — occurs when your rectum prolapses into the rear of your vagina
  • Uterine Prolapse — occurs when your uterus prolapses into the top of your vagina
  • Enterocele — occurs after a hysterectomy (removal of the uterus) when your small intestines prolapses into the top of your vagina 

What causes prolapse?

Prolapse occurs when there is a weakness in your pelvic muscles and the supporting tissues. Any number of factors and combinations of factors can cause prolapse including:

  • Pregnancies and multiple vaginal childbirths
  • Loss of muscle/tissue tone after menopause and your body’s loss of oestrogen
  • Weakening of your pelvic muscles with old age
  • Chronic cough
  • Constipation
  • Heavy lifting and over straining
  • Obesity
  • Major surgery inside your pelvic area
  • Abnormalities of the connective tissues  

What are the symptoms of prolapse?

Less severe forms of prolapse may only be discovered by a doctor during a vaginal examination and can often occur without any symptoms. Normally, no further treatment is necessary. However, if you have a more severe form of prolapse, you may experience:

  • a vaginal lump
  • a visible lump protruding from your vagina which may occur at the end of the day or with strenuous activity
  • vaginal discharge and bleeding
  • difficulties in passing urine, poor urine flow and a feeling of incomplete emptying of the bladder
  • urinary incontinence
  • difficulties in emptying the bowel
  • difficulties or uncomfortableness during sex
  • having to press on the prolapse with a finger in your vagina to help pass urine or bowel actions

Does prolapse cause urinary incontinence?

The weakening of the pelvic floor muscles and supportive tissues that cause prolapse also cause stress incontinence — which is why the two conditions are often found together. Your doctor may suggest surgery to repair the prolapse and for the stress incontinence at the same time.

Oftentimes, a large prolapse can create a kink the urethra and hide the problem of urinary incontinence. When the prolapse is repaired or pushed back into position with a pessary, urinary incontinence can sometimes reveal itself.

If incontinence is persistent or still a concern, it can easily be managed with the Depend® or Poise® range of incontinence products.

What treatments are available for prolapse?

Non-surgical

Less severe forms of prolapse may not require any treatment. Your doctor may adopt a ‘wait and see’ approach and suggest some ongoing Kegel exercises to keep your pelvic floor tight. More advanced prolapses can be treated non-surgically with a vaginal pessary — a small plastic device inserted into your vagina to support any prolapsed muscle or tissue and reposition it correctly. If incontinence is persistent or still a concern, it can easily be managed with the Depend® or Poise® range of incontinence products.

Which treatment option is best for you?

Your best treatment option is dependent upon a thorough evaluation of the prolapse by your doctor and consideration of multiple factors including:

  • the severity of your prolapse
  • the severity of your symptoms
  • a desire for more children, or a preference for retaining your uterus
  • any previous surgery for prolapse
    • consideration of the potential risks/complications of any the treatment options

What can you do to prevent further prolapse?

Doctors and medical experts believe some of the following measures might help prevent your prolapse from getting any worse and may help prevent any recurrence of prolapse after surgical treatment:

  • Stop smoking immediately
  • Perform regular Kegel exercises
  • Stay healthy and maintain a healthy weight
  • Try to avoid heavy lifting and straining where possible

Kimberly-Clark Australia makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional medical or other health professional advice.

Sources

Aua.com.au, (n.d.). Female Urology. [online] Available at: http://www.aua.com.au/content_common/pg-femaleurology.seo [Accessed 19 Apr. 2015].

Better Health Channel, (2013). Prolapsed uterus - Better Health Channel. [online] Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/prolapse_of_the_uterus [Accessed 19 Apr. 2015].

Continence.org.au, (2015). Pelvic organ prolapse ·Women ·  Continence Foundation of Australia. [online] Available at: http://www.continence.org.au/pages/prolapse.html [Accessed 19 Apr. 2015].

Hospital, T. (n.d.). More about surgery. [online] The Royal Women's Hospital. Available at: https://www.thewomens.org.au/health-information/vulva-vagina/vaginal-prolapse/more-about-surgery/ [Accessed 19 Apr. 2015].

Mydr.com.au, (2010). Prolapsed uterus - myDr.com.au. [online] Available at: http://www.mydr.com.au/womens-health/prolapsed-uterus [Accessed 19 Apr. 2015].

Poise.com.au, (2015). Prolapsed Uterus Health Information - Poise. [online] Available at: https://www.poise.com.au/female-incontinence/prolapse-uterus [Accessed 19 Apr. 2015].

Samreen, MBBS, S. and Lazarou, MD, FACOG, G. (2013). Prolapsed Uterus: When Is Surgery Appropriate?. [online] eMedicineHealth. Available at: http://www.emedicinehealth.com/prolapsed_uterus/article_em.htm [Accessed 19 Apr. 2015].

Trina Pagano, MD, T. (2013). Prolapsed Uterus Causes, Symptoms, Treatments. [online] Webmd.com. Available at: http://www.WebMD.com/women/guide/prolapsed-uterus [Accessed 19 Apr. 2015].

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