Pelvic organ prolapse – NHS

Pelvic organ prolapse is when 1 or more of the organs in the pelvis slip down from their normal position and bulge into the vagina.

It can be the womb (uterus), bowel, bladder or top of the vagina.

A prolapse is not life threatening, but it can cause pain and discomfort.

Symptoms can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed.

Symptoms of pelvic organ prolapse

Pelvic organ prolapse symptoms include:

• a feeling of heaviness around your lower tummy and genitals
• a dragging discomfort inside your vagina
• feeling like there’s something coming down into your vagina – it may feel like sitting on a small ball
• feeling or seeing a bulge or lump in or coming out of your vagina
• discomfort or numbness during sex
• problems peeing – such as feeling like your bladder is not emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise (stress incontinence)

Sometimes pelvic organ prolapse has no symptoms and is found during an internal examination carried out for another reason, such as cervical screening.

When to see a GP

See a GP if you have any of the symptoms of a prolapse, or if you notice a lump in or around your vagina.

What happens at your appointment

Your doctor will ask if they can do an internal pelvic examination.

For this you’ll need to undress from the waist down and lie back on the examination bed.

Your doctor will then feel for any lumps in your pelvic area and inside your vagina.

They may gently put an instrument called a speculum into your vagina to hold the walls of it open so they can see if there’s a prolapse.

Sometimes they’ll ask you to lie on your left-hand side and examine you in that position to get a better view of the prolapse.

You can ask for this examination to be done by a female doctor and, if you like, bring someone you trust along with you for support.

Further tests

If you have problems with your bladder, a GP may refer you to hospital for further tests.

These may include:

• a urine test to look for an infection
• inserting a small tube into your bladder to look for any problems

Treatment for pelvic organ prolapse

If you do not have any symptoms, or the prolapse is mild and not bothering you, you may not need medical treatment.

But making some lifestyle changes will probably still help.

These include:

• losing weight if you’re overweight
• avoiding heavy lifting
• preventing or treating constipation

If the prolapse is more severe or your symptoms are affecting your daily life, there are several further treatment options to consider.

These include:

• pelvic floor exercises
• hormone treatment
• vaginal pessaries
• surgery

The recommended treatment will depend on the type and severity of the prolapse, your symptoms and your overall health.

You and your doctor will decide together what’s the best option for you.

Causes of pelvic organ prolapse

Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and cannot hold the organs in place firmly.

A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse.

These include:

• pregnancy and childbirth – especially if you had a long, difficult birth, or if you gave birth to a large baby or multiple babies
• getting older and going through the menopause
• being overweight
• having long-term constipation or a long-term health condition that causes you to cough and strain
• having a hysterectomy
• a job that requires a lot of heavy lifting

Some health conditions can also make a prolapse more likely, including:

Types of prolapse

The 4 main types of prolapse are:

• the bladder bulging into the front wall of the vagina (anterior prolapse)
• the womb bulging or hanging down into the vagina (uterine prolapse)
• the top of the vagina sagging down – this happens to some women after they have had surgery to remove their womb
• the bowel bulging forward into the back wall of the vagina (posterior wall prolapse)

It’s possible to have more than 1 of these at the same time.

Pelvic organ prolapse will usually be classified on a scale of 1 to 4 to show how severe it is, with 4 being a severe prolapse.

Community content from HealthUnlocked

Page last reviewed: 24 March 2021
Next review due: 24 March 2024

Vaginal Prolapse: Symptoms, Causes, Treatments

Overview

Laparoscopic-Assisted Vaginal Tape Procedures for the treatment of Pelvic Organ Prolapse.

What is a vaginal prolapse?

A vaginal prolapse is a dropping of your vagina from its normal location in the body. The vagina, also called the birth canal, is the tunnel that connects the uterus to the outside of a woman’s body. Your vagina is one of several organs that rests in the pelvic area of your body. These organs are held in place by muscles and other tissue. These muscles come together to create a support structure. Throughout your life, this support structure can start to weaken. This can happen for a variety of reasons, but the result is a sagging of your organs. When your organs sag or droop out of their normal position, this is called a prolapse.

Prolapses can be small—with just a little movement—or large. A small prolapse is called an incomplete prolapse. A bigger prolapse (called a complete prolapse) is one where the organ has shifted significantly out of its normal place. A complete prolapse can result in part of the organ sticking out of the body. This is a very severe prolapse.

Are there different types of prolapse?

There are several different types of prolapse. Several of the organs in your pelvic area can shift out of place, developing into a prolapse. The different types of pelvic organ prolapse can include:

• Vaginal vault prolapse: The top of the vagina (known as the “vaginal vault”) droops down into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus).
• Uterine prolapse: The uterus bulges or slips into the vagina, sometimes so far that it comes out of the vaginal opening.
• Cystocele: The bladder drops into the vagina.
• Urethrocele: The urethra (the tube that carries urine away from the bladder) bulges into the vagina. A cystocele and urethrocele are often found together.
• Rectocele: The rectum bulges into or out of the vagina.
• Enterocele: The small intestine bulges against the back wall of the vagina. An enterocele and vaginal vault prolapse often occur together.

How common is vaginal prolapse?

Vaginal prolapse is fairly common. More than one-third of women in the U.S. have some type of pelvic area prolapse during their lifetime. You’re more likely to experience a vaginal prolapse later in life, especially if you have had multiple pregnancies with a vaginal birth.

Symptoms and Causes

What causes vaginal prolapse?

Your vagina is held in place within your pelvis by a group of muscles and other tissue—creating a support structure of sorts. This structure keeps the organs in your pelvis in place. Over time, this structure can weaken. When that happens, the vagina might slip down out of place, causing a prolapse. Several common causes of a vaginal prolapse can include:

• Childbirth: Vaginal delivery raises the risk of prolapse more than a cesarean section (when the baby is delivered through a surgical opening in the wall of the abdomen). It’s also thought that the more children a woman delivers, as well as the delivery of a large baby (more than 9 pounds), will raise the risk of prolapse.
• Surgery: A procedure like a hysterectomy, or radiation treatment in the pelvic area, could cause a prolapse.
• Menopause: During menopause, your ovaries stop producing hormones that regulate your monthly menstrual cycle (period). The hormone estrogen is particularly important because it helps keep your pelvic muscles strong. When your body doesn’t make as much estrogen as before, those pelvic muscles can become weak and a prolapse can develop.
• Aging: As you grow older, you are at a higher risk of forming a prolapse.
• Extreme physical activity or lifting of heavy objects: Strain from activity can also weaken your pelvic muscles and allow your organs to sag out of position.
• Genetic or hereditary factors: Your pelvic support system could naturally be weaker than typical. This can be passed down throughout your family.

Activities or conditions that place extra pressure on your abdominal area can also cause a prolapse. These can include:

• Being overweight.
• Straining to have a bowel movement.
• Having a chronic cough (such as in smokers or people with asthma).

What are the symptoms of vaginal prolapse?

In many cases, you may not feel any symptoms from a prolapse. You may find out about a vaginal prolapse during an exam in your healthcare provider’s office. If you do experience symptoms, they can include:

• A feeling of fullness, heaviness or pain in the pelvic area. This feeling often gets worse as the day goes on or after standing, lifting or coughing.
• Lower back pain.
• Bulging in the vagina.
• Organs slipping out of the vagina.
• Leakage of urine (urinary incontinence).
• Bladder infections.
• Difficulty having a bowel movement.
• Problems with sexual intercourse.
• Problems inserting tampons.

Diagnosis and Tests

How is vaginal prolapse diagnosed?

A vaginal prolapse is often diagnosed in your healthcare provider’s office during an appointment. Your provider will do a physical exam, talk to you about any symptoms of fullness in your pelvic area or urinary incontinence (leakage). You may also be asked about your family history and about any previous pregnancies.

In some cases, you may not have any symptoms and the prolapse could be found during a routine exam with your healthcare provider.

Management and Treatment

How is vaginal prolapse treated?

Treatment for vaginal prolapse can vary depending on the severity of your prolapse. In some cases, your healthcare provider may want to just watch it over time to make sure it doesn’t get worse.

There are non-surgical and surgical treatment options for vaginal prolapses. These treatments are very similar to treatment options for uterine prolapses. There are a few things your healthcare provider will take into account when forming a treatment plan. These can include:

• Your general health and if you have any other serious medical conditions.
• Your age.
• The severity of your prolapse.
• If you want to have children in the future.
• If you want to have penetrative sex in the future.

It’s important to have an open and honest conversation with your healthcare provider about these topics. Some of the treatment options can mean no longer being able to become pregnant or have intercourse. Talk to your healthcare provider about any questions or concerns you have regarding these treatments.

Non-surgical treatments are typically used as a first option and work best with very minimal prolapses. Specific non-surgical treatment options can include:

• Exercise: The muscles of your pelvis can be strengthened with exercises called Kegel exercises. To do these exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat this 10 times. You can do this up to four times a day and these exercises can be done anywhere.
• Vaginal pessary: Typically shaped like a small plastic or rubber doughnut, a pessary is a device that’s inserted into your vagina. It acts as a support structure, helping to hold things in place. A pessary is fitted and inserted by your healthcare provider. You will need to clean it frequently and remove it before having sex.
• For more severe cases, surgery can be a treatment option. These options include:
• Vaginal vault suspension: This procedure involves attaching the vagina to the ligaments inside the pelvis that used to hold it up. The surgery is done through a cut (incision) in the vagina.
• Sacrocolpopexy: This procedure involves attaching a piece of mesh to your vagina and securing the mesh to your tailbone to give the vagina a lift. This surgery is done through your abdomen, using small incisions and minimally invasive surgery called laparoscopy.
• Colpocliesis: This procedure involves stitching the vagina shut. An advantage of this surgery is the outcome—your risk of getting another prolapse is low. However, once this procedure is done, you can no longer have penetrative sex. A colpocliesis is more likely to be done in older women with prolapse.

Prevention

Can vaginal prolapse be prevented?

Often, you can’t prevent a vaginal prolapse. There are good lifestyle habits you can adopt to decrease your risk of developing a vaginal prolapse. These can include:

• Exercising regularly (Kegel exercises).
• Maintaining a healthy weight and diet.
• Not smoking.
• Using proper lifting techniques.

What are proper lifting techniques and how do they help prevent a prolapse?

When you lift something heavy, you can strain. This strain can lead to a prolapse. By following a few tips, you can lower your risk of prolapse.

• Don’t lift alone: When you have something that’s oddly shaped or very large, get help lifting it. Also, avoid lifting something above waist level.
• Check your footing: Make sure you have a good footing before lifting something.
• Lift with your legs: When you pick something up that’s lower than the level of your waist, keep your back straight and bend at your knees and hips. Do not bend forward at the waist with your knees straight.
• Use a wide stance: Keep your feet apart and firming on the ground when you lift something.
• Don’t jerk or twist when you lift something: Make sure that you straighten your knees in a steady motion and don’t jerk the object up to your body.
• Reposition objects before lifting: If you’re lifting an object from a table, slide it to the edge so that you can hold it close to your body.
• Hold packages close to your body: Keep your arms bent, your stomach muscles tight and hold the object closer to the core of your body.
• Take small steps: Don’t rush when moving with a package. Take your time and use small steps.
• Lower objects in the same way you picked them up: Place your feet apart, tighten your stomach muscles and bend at your hips and knees to lower an object.

Outlook / Prognosis

Can a vaginal prolapse happen again?

A vaginal prolapse can happen again after treatment. However, most treatment plans are very successful. If you have multiple prolapses or a severe prolapse, your healthcare provider may talk to you about surgical treatment options.

What’s the outlook for a vaginal prolapse?

In most cases, the outlook for a vaginal prolapse is positive. Treatment and lifestyle changes typically work well. Talk to your healthcare provider about all treatment options and what each option would mean for you. Your provider can help you develop good lifestyle habits that might help lower your risk of developing a vaginal prolapse in the future.

Vaginal Prolapse: Symptoms, Causes, Treatments

Overview

Laparoscopic-Assisted Vaginal Tape Procedures for the treatment of Pelvic Organ Prolapse.

What is a vaginal prolapse?

A vaginal prolapse is a dropping of your vagina from its normal location in the body. The vagina, also called the birth canal, is the tunnel that connects the uterus to the outside of a woman’s body. Your vagina is one of several organs that rests in the pelvic area of your body. These organs are held in place by muscles and other tissue. These muscles come together to create a support structure. Throughout your life, this support structure can start to weaken. This can happen for a variety of reasons, but the result is a sagging of your organs. When your organs sag or droop out of their normal position, this is called a prolapse.

Prolapses can be small—with just a little movement—or large. A small prolapse is called an incomplete prolapse. A bigger prolapse (called a complete prolapse) is one where the organ has shifted significantly out of its normal place. A complete prolapse can result in part of the organ sticking out of the body. This is a very severe prolapse.

Are there different types of prolapse?

There are several different types of prolapse. Several of the organs in your pelvic area can shift out of place, developing into a prolapse. The different types of pelvic organ prolapse can include:

• Vaginal vault prolapse: The top of the vagina (known as the “vaginal vault”) droops down into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus).
• Uterine prolapse: The uterus bulges or slips into the vagina, sometimes so far that it comes out of the vaginal opening.
• Cystocele: The bladder drops into the vagina.
• Urethrocele: The urethra (the tube that carries urine away from the bladder) bulges into the vagina. A cystocele and urethrocele are often found together.
• Rectocele: The rectum bulges into or out of the vagina.
• Enterocele: The small intestine bulges against the back wall of the vagina. An enterocele and vaginal vault prolapse often occur together.

How common is vaginal prolapse?

Vaginal prolapse is fairly common. More than one-third of women in the U.S. have some type of pelvic area prolapse during their lifetime. You’re more likely to experience a vaginal prolapse later in life, especially if you have had multiple pregnancies with a vaginal birth.

Symptoms and Causes

What causes vaginal prolapse?

Your vagina is held in place within your pelvis by a group of muscles and other tissue—creating a support structure of sorts. This structure keeps the organs in your pelvis in place. Over time, this structure can weaken. When that happens, the vagina might slip down out of place, causing a prolapse. Several common causes of a vaginal prolapse can include:

• Childbirth: Vaginal delivery raises the risk of prolapse more than a cesarean section (when the baby is delivered through a surgical opening in the wall of the abdomen). It’s also thought that the more children a woman delivers, as well as the delivery of a large baby (more than 9 pounds), will raise the risk of prolapse.
• Surgery: A procedure like a hysterectomy, or radiation treatment in the pelvic area, could cause a prolapse.
• Menopause: During menopause, your ovaries stop producing hormones that regulate your monthly menstrual cycle (period). The hormone estrogen is particularly important because it helps keep your pelvic muscles strong. When your body doesn’t make as much estrogen as before, those pelvic muscles can become weak and a prolapse can develop.
• Aging: As you grow older, you are at a higher risk of forming a prolapse.
• Extreme physical activity or lifting of heavy objects: Strain from activity can also weaken your pelvic muscles and allow your organs to sag out of position.
• Genetic or hereditary factors: Your pelvic support system could naturally be weaker than typical. This can be passed down throughout your family.

Activities or conditions that place extra pressure on your abdominal area can also cause a prolapse. These can include:

• Being overweight.
• Straining to have a bowel movement.
• Having a chronic cough (such as in smokers or people with asthma).

What are the symptoms of vaginal prolapse?

In many cases, you may not feel any symptoms from a prolapse. You may find out about a vaginal prolapse during an exam in your healthcare provider’s office. If you do experience symptoms, they can include:

• A feeling of fullness, heaviness or pain in the pelvic area. This feeling often gets worse as the day goes on or after standing, lifting or coughing.
• Lower back pain.
• Bulging in the vagina.
• Organs slipping out of the vagina.
• Leakage of urine (urinary incontinence).
• Bladder infections.
• Difficulty having a bowel movement.
• Problems with sexual intercourse.
• Problems inserting tampons.

Diagnosis and Tests

How is vaginal prolapse diagnosed?

A vaginal prolapse is often diagnosed in your healthcare provider’s office during an appointment. Your provider will do a physical exam, talk to you about any symptoms of fullness in your pelvic area or urinary incontinence (leakage). You may also be asked about your family history and about any previous pregnancies.

In some cases, you may not have any symptoms and the prolapse could be found during a routine exam with your healthcare provider.

Management and Treatment

How is vaginal prolapse treated?

Treatment for vaginal prolapse can vary depending on the severity of your prolapse. In some cases, your healthcare provider may want to just watch it over time to make sure it doesn’t get worse.

There are non-surgical and surgical treatment options for vaginal prolapses. These treatments are very similar to treatment options for uterine prolapses. There are a few things your healthcare provider will take into account when forming a treatment plan. These can include:

• Your general health and if you have any other serious medical conditions.
• Your age.
• The severity of your prolapse.
• If you want to have children in the future.
• If you want to have penetrative sex in the future.

It’s important to have an open and honest conversation with your healthcare provider about these topics. Some of the treatment options can mean no longer being able to become pregnant or have intercourse. Talk to your healthcare provider about any questions or concerns you have regarding these treatments.

Non-surgical treatments are typically used as a first option and work best with very minimal prolapses. Specific non-surgical treatment options can include:

• Exercise: The muscles of your pelvis can be strengthened with exercises called Kegel exercises. To do these exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat this 10 times. You can do this up to four times a day and these exercises can be done anywhere.
• Vaginal pessary: Typically shaped like a small plastic or rubber doughnut, a pessary is a device that’s inserted into your vagina. It acts as a support structure, helping to hold things in place. A pessary is fitted and inserted by your healthcare provider. You will need to clean it frequently and remove it before having sex.
• For more severe cases, surgery can be a treatment option. These options include:
• Vaginal vault suspension: This procedure involves attaching the vagina to the ligaments inside the pelvis that used to hold it up. The surgery is done through a cut (incision) in the vagina.
• Sacrocolpopexy: This procedure involves attaching a piece of mesh to your vagina and securing the mesh to your tailbone to give the vagina a lift. This surgery is done through your abdomen, using small incisions and minimally invasive surgery called laparoscopy.
• Colpocliesis: This procedure involves stitching the vagina shut. An advantage of this surgery is the outcome—your risk of getting another prolapse is low. However, once this procedure is done, you can no longer have penetrative sex. A colpocliesis is more likely to be done in older women with prolapse.

Prevention

Can vaginal prolapse be prevented?

Often, you can’t prevent a vaginal prolapse. There are good lifestyle habits you can adopt to decrease your risk of developing a vaginal prolapse. These can include:

• Exercising regularly (Kegel exercises).
• Maintaining a healthy weight and diet.
• Not smoking.
• Using proper lifting techniques.

What are proper lifting techniques and how do they help prevent a prolapse?

When you lift something heavy, you can strain. This strain can lead to a prolapse. By following a few tips, you can lower your risk of prolapse.

• Don’t lift alone: When you have something that’s oddly shaped or very large, get help lifting it. Also, avoid lifting something above waist level.
• Check your footing: Make sure you have a good footing before lifting something.
• Lift with your legs: When you pick something up that’s lower than the level of your waist, keep your back straight and bend at your knees and hips. Do not bend forward at the waist with your knees straight.
• Use a wide stance: Keep your feet apart and firming on the ground when you lift something.
• Don’t jerk or twist when you lift something: Make sure that you straighten your knees in a steady motion and don’t jerk the object up to your body.
• Reposition objects before lifting: If you’re lifting an object from a table, slide it to the edge so that you can hold it close to your body.
• Hold packages close to your body: Keep your arms bent, your stomach muscles tight and hold the object closer to the core of your body.
• Take small steps: Don’t rush when moving with a package. Take your time and use small steps.
• Lower objects in the same way you picked them up: Place your feet apart, tighten your stomach muscles and bend at your hips and knees to lower an object.

Outlook / Prognosis

Can a vaginal prolapse happen again?

A vaginal prolapse can happen again after treatment. However, most treatment plans are very successful. If you have multiple prolapses or a severe prolapse, your healthcare provider may talk to you about surgical treatment options.

What’s the outlook for a vaginal prolapse?

In most cases, the outlook for a vaginal prolapse is positive. Treatment and lifestyle changes typically work well. Talk to your healthcare provider about all treatment options and what each option would mean for you. Your provider can help you develop good lifestyle habits that might help lower your risk of developing a vaginal prolapse in the future.

Vaginal Prolapse: Symptoms, Causes, Treatments

Overview

Laparoscopic-Assisted Vaginal Tape Procedures for the treatment of Pelvic Organ Prolapse.

What is a vaginal prolapse?

A vaginal prolapse is a dropping of your vagina from its normal location in the body. The vagina, also called the birth canal, is the tunnel that connects the uterus to the outside of a woman’s body. Your vagina is one of several organs that rests in the pelvic area of your body. These organs are held in place by muscles and other tissue. These muscles come together to create a support structure. Throughout your life, this support structure can start to weaken. This can happen for a variety of reasons, but the result is a sagging of your organs. When your organs sag or droop out of their normal position, this is called a prolapse.

Prolapses can be small—with just a little movement—or large. A small prolapse is called an incomplete prolapse. A bigger prolapse (called a complete prolapse) is one where the organ has shifted significantly out of its normal place. A complete prolapse can result in part of the organ sticking out of the body. This is a very severe prolapse.

Are there different types of prolapse?

There are several different types of prolapse. Several of the organs in your pelvic area can shift out of place, developing into a prolapse. The different types of pelvic organ prolapse can include:

• Vaginal vault prolapse: The top of the vagina (known as the “vaginal vault”) droops down into the vaginal canal. This usually occurs in women who have had a hysterectomy (removal of the uterus).
• Uterine prolapse: The uterus bulges or slips into the vagina, sometimes so far that it comes out of the vaginal opening.
• Cystocele: The bladder drops into the vagina.
• Urethrocele: The urethra (the tube that carries urine away from the bladder) bulges into the vagina. A cystocele and urethrocele are often found together.
• Rectocele: The rectum bulges into or out of the vagina.
• Enterocele: The small intestine bulges against the back wall of the vagina. An enterocele and vaginal vault prolapse often occur together.

How common is vaginal prolapse?

Vaginal prolapse is fairly common. More than one-third of women in the U.S. have some type of pelvic area prolapse during their lifetime. You’re more likely to experience a vaginal prolapse later in life, especially if you have had multiple pregnancies with a vaginal birth.

Symptoms and Causes

What causes vaginal prolapse?

Your vagina is held in place within your pelvis by a group of muscles and other tissue—creating a support structure of sorts. This structure keeps the organs in your pelvis in place. Over time, this structure can weaken. When that happens, the vagina might slip down out of place, causing a prolapse. Several common causes of a vaginal prolapse can include:

• Childbirth: Vaginal delivery raises the risk of prolapse more than a cesarean section (when the baby is delivered through a surgical opening in the wall of the abdomen). It’s also thought that the more children a woman delivers, as well as the delivery of a large baby (more than 9 pounds), will raise the risk of prolapse.
• Surgery: A procedure like a hysterectomy, or radiation treatment in the pelvic area, could cause a prolapse.
• Menopause: During menopause, your ovaries stop producing hormones that regulate your monthly menstrual cycle (period). The hormone estrogen is particularly important because it helps keep your pelvic muscles strong. When your body doesn’t make as much estrogen as before, those pelvic muscles can become weak and a prolapse can develop.
• Aging: As you grow older, you are at a higher risk of forming a prolapse.
• Extreme physical activity or lifting of heavy objects: Strain from activity can also weaken your pelvic muscles and allow your organs to sag out of position.
• Genetic or hereditary factors: Your pelvic support system could naturally be weaker than typical. This can be passed down throughout your family.

Activities or conditions that place extra pressure on your abdominal area can also cause a prolapse. These can include:

• Being overweight.
• Straining to have a bowel movement.
• Having a chronic cough (such as in smokers or people with asthma).

What are the symptoms of vaginal prolapse?

In many cases, you may not feel any symptoms from a prolapse. You may find out about a vaginal prolapse during an exam in your healthcare provider’s office. If you do experience symptoms, they can include:

• A feeling of fullness, heaviness or pain in the pelvic area. This feeling often gets worse as the day goes on or after standing, lifting or coughing.
• Lower back pain.
• Bulging in the vagina.
• Organs slipping out of the vagina.
• Leakage of urine (urinary incontinence).
• Bladder infections.
• Difficulty having a bowel movement.
• Problems with sexual intercourse.
• Problems inserting tampons.

Diagnosis and Tests

How is vaginal prolapse diagnosed?

A vaginal prolapse is often diagnosed in your healthcare provider’s office during an appointment. Your provider will do a physical exam, talk to you about any symptoms of fullness in your pelvic area or urinary incontinence (leakage). You may also be asked about your family history and about any previous pregnancies.

In some cases, you may not have any symptoms and the prolapse could be found during a routine exam with your healthcare provider.

Management and Treatment

How is vaginal prolapse treated?

Treatment for vaginal prolapse can vary depending on the severity of your prolapse. In some cases, your healthcare provider may want to just watch it over time to make sure it doesn’t get worse.

There are non-surgical and surgical treatment options for vaginal prolapses. These treatments are very similar to treatment options for uterine prolapses. There are a few things your healthcare provider will take into account when forming a treatment plan. These can include:

• Your general health and if you have any other serious medical conditions.
• Your age.
• The severity of your prolapse.
• If you want to have children in the future.
• If you want to have penetrative sex in the future.

It’s important to have an open and honest conversation with your healthcare provider about these topics. Some of the treatment options can mean no longer being able to become pregnant or have intercourse. Talk to your healthcare provider about any questions or concerns you have regarding these treatments.

Non-surgical treatments are typically used as a first option and work best with very minimal prolapses. Specific non-surgical treatment options can include:

• Exercise: The muscles of your pelvis can be strengthened with exercises called Kegel exercises. To do these exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat this 10 times. You can do this up to four times a day and these exercises can be done anywhere.
• Vaginal pessary: Typically shaped like a small plastic or rubber doughnut, a pessary is a device that’s inserted into your vagina. It acts as a support structure, helping to hold things in place. A pessary is fitted and inserted by your healthcare provider. You will need to clean it frequently and remove it before having sex.
• For more severe cases, surgery can be a treatment option. These options include:
• Vaginal vault suspension: This procedure involves attaching the vagina to the ligaments inside the pelvis that used to hold it up. The surgery is done through a cut (incision) in the vagina.
• Sacrocolpopexy: This procedure involves attaching a piece of mesh to your vagina and securing the mesh to your tailbone to give the vagina a lift. This surgery is done through your abdomen, using small incisions and minimally invasive surgery called laparoscopy.
• Colpocliesis: This procedure involves stitching the vagina shut. An advantage of this surgery is the outcome—your risk of getting another prolapse is low. However, once this procedure is done, you can no longer have penetrative sex. A colpocliesis is more likely to be done in older women with prolapse.

Prevention

Can vaginal prolapse be prevented?

Often, you can’t prevent a vaginal prolapse. There are good lifestyle habits you can adopt to decrease your risk of developing a vaginal prolapse. These can include:

• Exercising regularly (Kegel exercises).
• Maintaining a healthy weight and diet.
• Not smoking.
• Using proper lifting techniques.

What are proper lifting techniques and how do they help prevent a prolapse?

When you lift something heavy, you can strain. This strain can lead to a prolapse. By following a few tips, you can lower your risk of prolapse.

• Don’t lift alone: When you have something that’s oddly shaped or very large, get help lifting it. Also, avoid lifting something above waist level.
• Check your footing: Make sure you have a good footing before lifting something.
• Lift with your legs: When you pick something up that’s lower than the level of your waist, keep your back straight and bend at your knees and hips. Do not bend forward at the waist with your knees straight.
• Use a wide stance: Keep your feet apart and firming on the ground when you lift something.
• Don’t jerk or twist when you lift something: Make sure that you straighten your knees in a steady motion and don’t jerk the object up to your body.
• Reposition objects before lifting: If you’re lifting an object from a table, slide it to the edge so that you can hold it close to your body.
• Hold packages close to your body: Keep your arms bent, your stomach muscles tight and hold the object closer to the core of your body.
• Take small steps: Don’t rush when moving with a package. Take your time and use small steps.
• Lower objects in the same way you picked them up: Place your feet apart, tighten your stomach muscles and bend at your hips and knees to lower an object.

Outlook / Prognosis

Can a vaginal prolapse happen again?

A vaginal prolapse can happen again after treatment. However, most treatment plans are very successful. If you have multiple prolapses or a severe prolapse, your healthcare provider may talk to you about surgical treatment options.

What’s the outlook for a vaginal prolapse?

In most cases, the outlook for a vaginal prolapse is positive. Treatment and lifestyle changes typically work well. Talk to your healthcare provider about all treatment options and what each option would mean for you. Your provider can help you develop good lifestyle habits that might help lower your risk of developing a vaginal prolapse in the future.

Pelvic Prolapse | University of Utah Health

Muscles in your pelvis hold up and support your:

• bladder,
• intestines,
• rectum,
• uterus, and
• vagina.

Together, these muscles make up your pelvic floor.

Over time, your pelvic muscles and connective tissue can tear, stretch, or get weak. When this happens, your organs can drop. This is called pelvic prolapse, pelvic organ prolapse, or just prolapse. (“Prolapse” means “to slip forward” or “slip down”).

Prolapse can also be considered a hernia that goes into your vagina.

If you think you may have prolapse, you’re not alone. In fact, 70 percent of women will get some form of prolapse, even if it’s very mild.  

What Does Prolapse Feel Like?

Prolapse can feel different for each woman. Some women say it feels like they’re sitting on a ball all the time. Other women feel fullness or pressure around their vagina, bladder, or pelvic area.

The most obvious way to tell if you have prolapse is if you feel a bump or “bulge” at the bottom of your vagina. That bulge is tissue from your organs that has fallen downward through your vagina.

Types of Prolapse

There are different kinds of prolapse:

Cystocele or urethrocele—this is when your bladder falls down into your vagina. If the cystocele or urethrocele is severe, the organs that have fallen down may stick out or “bulge” out of the bottom of your vagina. Cystoceles and urethroceles are common in women who’ve had hysterectomies because the uterus is no longer sitting inside the pelvic area.

Women with this type of prolapse may have bladder problems as well. Problems can include urinating often, not being able to control when you pee (loss of bladder control), and getting frequent bladder infections.

Enterocele or rectocele—if you have an enterocele or rectocele, your intestines or rectum slide into your vagina. (A rectocele is when your rectum slides into your vagina; an enterocele is when your intestines slide into your vagina).

If you have either of these, it may be hard for you to make a bowel movement (poop). You may also feel like you can’t ever fully empty your bowels.

Uterine prolapse—this type of prolapse happens when your uterus falls down into your vagina. If you feel pressure around your pelvis, you may have uterine prolapse. Your cervix may also stick out of the opening of your vagina.

Pelvic Organ Prolapse (POP) – Women’s Health Issues

Surgery is done if symptoms persist after women have tried pelvic floor exercises and a pessary. Surgery is also an option for women who do not wish to use a pessary. Surgery is usually done only after a woman has decided not to have any more children.

One of the following types of surgery is used:

• Vaginal surgery: Surgery is done through the vagina rather than the abdomen. In such cases, no external incision is needed.

• Abdominal surgery: One or more incisions are made in the abdomen.

In general, vaginal surgery causes fewer problems than abdominal surgery, and the recovery is quicker.

Abdominal surgery includes the following:

• Laparotomy: An incision that is several inches long is made in the abdomen.

• Laparoscopic surgery: A viewing tube (laparoscope) and surgical instruments are inserted through several tiny incisions in the lower part of the abdomen.

The weakened area is located, and the tissues around it are built up to prevent the organ from dropping through the weakened area.

For rectoceles, enteroceles, cystoceles, and cystourethroceles, procedures may include the following:

• Repair of the tissues that normally support the vagina (colporrhaphy).

• Repair of the tissues between the opening of the vagina and the anus (perineorrhaphy).

For these two procedures, surgery is done through the vagina. These procedures do not require an incision in the abdomen.

For severe prolapse of the uterus or vagina, treatment may include

• Removal of the uterus, if still present (hysterectomy)

• Repair of the tissues that support the uterus and vagina (colporrhaphy)

• Repair the tissues between the opening of the vagina and the anus (perineorrhaphy)

• Attachment of the upper part of the vagina (with stitches) to a nearby stable structure, such as a bone or strong ligament in the pelvis (sacrospinous ligament fixation)

• Closure of the vagina (colpocleisis) after removal of the uterus or with the uterus in place (called the Le Fort procedure)

Surgery is delayed until any sores on the protruding vagina have healed.

Closure of the vagina (colpocleisis) is an option for women who have severe vaginal prolapse and who do not plan to be sexually active. For this procedure, part of the vagina’s lining is removed, and the vagina is stitched shut. Because this procedure can be done quickly and causes few complications, it may be a good choice for women who have conditions that make surgery risky (such as a heart disorder). Also, after closure, prolapse is unlikely to recur. However, vaginal intercourse is no longer possible.

After surgery to correct a pelvic organ prolapse, a catheter may be inserted in the bladder until the bladder starts functioning normally. Ideally, the catheter is removed within 24 hours.

Recovery time depends on the type of surgery. Most women can gradually resume their normal physical activity over a period of a few weeks, depending on the surgery. Lifting heavy objects (more than 10 pounds) may interfere with healing and should be avoided for at least 6 weeks after surgery to correct pelvic organ prolapse.

6 Signs of Prolapse: John Macey, MD: OB/GYN

Pelvic organ prolapse occurs when the uterus or bladder slips down toward the rectum or vagina. 

These organs usually slip out of place when the tissues that support them are weakened or damaged. Damage to the supporting tissues may occur as a result of lifting heavy weights, being overweight or obese, or going through several vaginal births. In some cases, severe and chronic constipation may also lead to organ prolapse.

Dr. John Macey regularly treats women suffering from uterine and bladder prolapse at his OB/GYN practice in Nashville, Tennessee. In this blog, he discusses six signs of pelvic organ prolapse and some of the treatment options that are available.

Signs of pelvic organ prolapse

The following are some of the most common signs of this condition:

1. Excessive discharge

Some discharge from the vagina is normal. However, if you notice an increase in the discharge, it could be a sign of an underlying condition. The discharge usually worsens when standing up for prolonged periods and improves after lying down.

2. Bloating and fullness in the abdomen 

If an organ slips down, you may feel bloated in your lower abdomen area. Some women also experience gas, a symptom that’s often confused with digestive issues. 

3. Back pain and pressure 

In the first stage of prolapse, you may feel some mild pressure in your vagina as well as mild back pain. Left untreated, the prolapse may advance and lead to more pressure and pain. 

During the later stages, you may also notice tissue protruding from your vaginal opening. 

4. Bowel problems 

Constipation and the feeling of not completely emptying your bowels may be a sign that either the uterus or bladder is slipping out of place. 

5. Urinary difficulties 

Stress incontinence — urine leakages caused by sneezing, coughing, or lifting heavy objects — is often a sign of bladder prolapse. 

If you’re suffering from bladder prolapse, you may also experience frequent urinary infections and difficulties emptying your bladder. Left untreated, bladder prolapse may obstruct the kidneys.

6. Vaginal bleeding

In moderate to severe stages of organ prolapse, you may also notice some bleeding. This is because the organ that’s protruding through your vagina can get irritated if it comes in contact with your underwear. 

Treating pelvic organ prolapse 

Severe organ prolapse is fixable thanks to minimally invasive procedures, such as laparoscopy, which allows surgeons to operate on the abdomen and pelvis without making large incisions. With laparoscopy, Dr. Macey can repair the damaged tissues in your pelvic floor to prevent the prolapsed organ from sinking.

If you have a milder case of prolapse, surgical intervention may not be necessary. Instead, you may be able to stop the progression of the prolapse by making a few lifestyle changes, such as losing weight or doing Kegel exercises to strengthen your pelvic floor muscles.

If you have symptoms that lead you to believe you have a prolapsed organ, Dr. Macey can give you a thorough evaluation and help you get healthy. To learn more, book an appointment online or over the phone with the practice of Dr. John Macey today.

90,000 GENITAL PROLapse – Pelvic prolapse and prolapse

Pelvic organ prolapse is a chronic disease resulting from weakening of the musculo-ligamentous apparatus of the pelvic organs, leading to prolapse of the vaginal walls and prolapse of the uterus. The displacement of the internal genital organs forms a hernial protrusion into the lumen of the vagina, which goes beyond the genital slit in the later stages.

Descent of only the anterior wall of the vagina is a cystocele, prolapse of the posterior wall is rectocele.

The increase in the incidence is currently acquiring the scale of a latent and silent epidemic.

The main cause of pelvic organ prolapse is the failure of the muscles of the pelvic floor and abdominal wall, which often occurs after birth through the vaginal birth canal, dysplasia of connective tissue and collagen synthesis.

SYMPTOMS

Patients with prolapse and prolapse of the pelvic organs experience a feeling of “foreign body” and discomfort in the external genital area, “heaviness” in the perineum and in the lower abdomen.

Cystocele can cause urinary disorders, including latent urinary incontinence and an increase in the amount of residual urine, as well as urinary retention.

Women with posterior wall prolapse – rectocele usually have rectal dysfunction, fecal and gas incontinence or fecal and gas retention. Frequent stool retention leads to tension, increased intra-abdominal pressure and, as a result, further progression of prolapse and rectocele.

DIAGNOSTICS

On examination, as a rule, the genital gap gapes, the walls of the vagina and cervix are lowered, in some cases incomplete and complete prolapse of the pelvic organs, decubital ulcers due to maceration of the cervix and the walls of the vagina with linen are noted.Ultrasound provides essential assistance in assessing the condition of the pelvic floor.

TREATMENT OF PELVIC ORGAN PROLAPSE

In treatment, we use urogynecological pessaries, which allow you to restore the anatomical position of the body and cervix, prevent involuntary urination during exertion, coughing, sneezing and heavy lifting, prevent further progression of prolapse of the pelvic organs and the ability to postpone the operation.

90,000 Causes and symptoms of prolapse (prolapse) of the uterus in women after childbirth

Causes of prolapse (prolapse) of the uterus

All organs of the abdominal cavity are relatively mobile. Under the influence of various factors, they change their position, slightly shifting to one side or the other. But due to certain injuries, excessive and constant physical exertion, and other problems, slow prolapse and even prolapse of the genitals can occur. We can talk about the main and secondary causes of prolapse of the uterus and prolapse of the walls of the vagina.

Displacement of the uterus provokes circulatory disorders in the pelvic organs, inflammation and gradual death of mucous membranes, tissue edema. The situation is complicated by the fact that many women do not notice any deviations in the initial stages of the disease. At first, there is only a feeling of excessive pressure in the lower abdomen, it can be accompanied by pulling pains, as before the next menstruation. Sometimes there is pain in the lower back or sacral spine. All this suggests that the pelvic organs are displaced and are no longer in their places.

Later, problems with urination begin. A little less often, but also quite often, there are proctological complications: constipation or inflammation of the colon.
Usually, it is at the stage of urological and proctological problems that the patient turns to the doctor.

The main causes of the development of the disease

The occurrence of this disease can be associated with a whole range of reasons.

1. Pregnancy and childbirth.

Most often, prolapse or prolapse of the uterus is associated with pregnancy and natural childbirth.In the process of the birth of a baby, tears and injuries of the perineum quite often occur, which are accompanied by inevitable damage to the muscles of the pelvic floor.

The more a woman has a history of natural childbirth, the more likely it is that sooner or later she will face the problem of prolapse or even prolapse of the uterus.

Incorrect presentation of the baby in the womb and extraction by the buttocks, incorrect suturing of incisions along with the lack of timely postpartum rehabilitation can lead to a similar pathology.According to statistics, women who have 4 or more children are most prone to this disease. After the first birth, the probability of prolapse of the uterus rises to 50% and increases by 10-20% with each subsequent birth.

2. Excessive physical activity.

Any stress associated with straining is a risk factor and can cause prolapse of the uterus. Moreover, we are talking about loads of various kinds: from lifting weights in everyday life to professional sports.

The reason for the prolapse of the uterus can be overly zealous sports, especially when it comes to strength training, exercises with weights and dumbbells, bodybuilding.

But even if a woman has never been involved in professional sports, she can also be diagnosed with prolapse of the uterus associated with exertion. We are talking about the constant lifting of weights, that is, any objects weighing more than 3 kg. Any excessive hard and regular physical labor puts the female body in jeopardy, which means it is a risk factor.

3. Heredity and lifestyle.

According to recent studies, people with an asthenic constitution, that is, tall and fragile, are more prone to uterine prolapse. In women with such a figure, this disease develops much more often. In addition, this pathology is common among women and girls, whose mothers, sisters or other female relatives have already suffered uterine prolapse. Thus, the hereditary factor also plays a very important role.

Risk factors

The list of dangers is not limited to the named reasons only.Unfortunately, life itself in modern society is already a risk factor. So, a regular delay in the emptying of the bladder or rectum in kindergarten, then at school, university and at work leads to increased pressure on the uterus. Because of this, the uterine ligaments stretch and weaken, which becomes the reason for the prolapse or prolapse of the uterus. You can also talk about some individual characteristics that are included in the list of risk factors.

1. Age.

With age, the risk of prolapse of the uterus or vagina increases.According to statistics, each passing decade increases the likelihood of developing prolapse or prolapse of the uterus. The reasons for this relationship have not yet been fully studied by specialists. However, practice shows that after 60 years, every second woman is forced to deal with the problem of prolapse of the uterus. This is most often associated with an acute estrogen deficiency that occurs during menopause.

2. Overweight.

Studies have shown that an increased body mass index can also be one of the causes of uterine prolapse.Perhaps the fact is that being overweight in general increases the load on internal organs and systems and contributes to the deterioration of the general condition of the body.

3. Health problems.

Some cancers can provoke an excessive load on the ligamentous apparatus of the uterus and cause prolapse. Among them are fibroids, fibroids, leiomyomas, as well as ovarian cysts.

In general, any chronic diseases associated with increased intra-abdominal pressure (chronic constipation, cough, etc.)can contribute to the development of this pathology.

4. Nationality.

Even racial differences in the structure of internal organs in women in one way or another affect the risk of prolapse of the uterus. The risk of uterine prolapse is highest in Spanish, Asian and Caucasian women. Europeans are approximately in third place in terms of the incidence of this disease. African-American women are less likely to experience prolapse of internal organs due to the fact that they have a smaller exit plane of the small pelvis, which means that the load on the pelvic floor muscles is lower.

Pelvic organ prolapse and prolapse: symptoms, treatment, surgery

Symptoms

The symptoms of the disease directly depend on the organ that was involved in the pathological process. Given this fact, the following symptom complexes can be distinguished:

1. Associated with prolapse of the bladder: Difficulty urinating, a feeling of incomplete emptying of the bladder, frequent urination, urination in small portions, harsh (imperative) urge to urinate, loss of urine on the background of physical exertion or with urgent urge
2. Associated with prolapse of the rectum: difficult defecation, the need to help with the hand (press on the descending walls of the vagina) during bowel movements.
3. Associated with prolapse of the uterus: pulling pain in the lower abdomen, discomfort during sexual intercourse.

At the same time, the main symptom characteristic of all patients and leading them to a doctor is the feeling of a foreign body in the vagina. Moreover, most patients have a violation of the support of several organs at once, and therefore the clinical picture may be more multifaceted than described above.

Reasons

The main reason for the prolapse of the pelvic organs is damage to the pelvic floor support apparatus. The main elements of the latter are the ligaments and fascia, which braid the pelvic organs and fix (hang) them to the walls of the pelvis. It can be compared to the lines of a parachute. The muscles of the pelvis and perineum act as support for the ligaments and fascia.

That is why at a young age with preserved muscle tone, prolapse of the pelvic organs is quite rare, at the same time, after 50 years, every second woman suffers from it. At the moment, there is no consensus about the cause of the development of this disease, most likely it, like most pathologies, has a multifactorial nature. At the same time, the following main reasons can be distinguished:

1. Pregnancy and childbirth. During this period, there is a change in the qualitative composition of the pelvic floor tissues – they become more elastic and extensible.In some patients, unfortunately, the restoration of the previous properties of the ligaments and fascia does not occur. On the other hand, during childbirth, parts of the fascia, ligaments and muscles are damaged. This is especially true in the case of complicated labor (large fetus, rapid labor, episiotomy (perineal incision), use of obstetric forceps, vacuum, etc.) during labor.
2. Hard physical work. A process similar to childbirth develops here – the supporting structures of the pelvis simply cannot withstand the stress and are torn.
3. Chronic constipation, respiratory diseases (accompanied by persistent cough). This also includes obesity, which is also accompanied by increased loads on the ligamentous apparatus of the pelvic floor.
4. Of course, hereditary connective tissue weakness also contributes. Often such women have such concomitant diseases as hemorrhoids, varicose veins of the lower extremities, pathology of the musculoskeletal system.

Diagnostics

Diagnosis of pelvic organ prolapse does not cause difficulties for a specialist dealing with this issue. It is enough to conduct a standard gynecological examination and perform several provocative tests (pushing or coughing hard).During the examination, it will be possible to tell which part of the vagina / organ is most affected: the anterior wall / bladder, the upper part of the vagina / uterus and the posterior wall of the vagina / rectum.

The degree of prolapse is also determined: if the descended organs do not go beyond the vagina, then this is 1 or 2 degree; if this happened, then grade 3 or 4 (with complete prolapse of the vaginal walls). Unfortunately, doctors who do not treat these patients often incorrectly assess the degree of the disease and incorrectly determine those parts of the pelvic floor that are involved in it.For the most part, problems in the treatment of this category of patients are associated with errors at the diagnostic stage.

Treatment

Treatment of pelvic organ prolapse is perhaps the most difficult issue. First, it is necessary to treat the disease only if there are complaints. Second, and most importantly, the management of each patient should be strictly individual. All types of treatment for pelvic organ prolapse can be divided into conservative and surgical.

The first treatment option can be useful in the initial stages (1-2) of prolapse, for young patients, or when surgical treatment for some reason (the patient’s serious condition or the patient’s unwillingness to be operated on) cannot be performed.Among the non-surgical methods, the most relevant are the following: training of the pelvic floor muscles (Kegel exercises or biofeedback therapy) and pessaries. Unfortunately, these methods most often only slow down the progression of the disease.

Operation

Of course, they will not replace damaged ligaments and fascia. Surgical treatment for severe forms of prolapse is the only effective treatment. The most popular, well-researched, and most natural are the operations performed through the vagina.In this case, it is possible to restore all parts of the pelvic floor and achieve an excellent cosmetic result with minimal risks to the patient.

At the present stage of the development of medicine, the so-called hybrid techniques have become widespread, which allow restoring the natural anatomy of the pelvic floor through a combination of organ-preserving techniques, the maximum use of the patient’s own tissues and the point / targeted use of synthetic materials in the most congested areas.

Fixation of the uterus during prolapse / prolapse

The prolapse or prolapse of the uterus and other internal genital organs is noted today in 50% of women giving birth. During pregnancy, the fetus puts constant pressure on the pelvic muscles, relaxing them. With a gradual weakening of the muscles and ligaments, the walls of the vagina descend. In this case, a diagnosis of genital prolapse is made.

By the age of 30, the perineal tissue becomes less elastic.

If the first birth occurs at this age, then the risk of tissue injury and, consequently, prolapse of the internal genital organs increases.

Main causes of genital prolapse:
– chronic constipation,
– diabetes mellitus, obesity, hormonal disorders,
– constant weight lifting,
– frequent bouts of severe coughing,
– congenital weakness of the connective tissue.

The prolapse of the internal genital organs occurs gradually.

There are 5 degrees of this process:
First degree – there is a slight descent of the posterior and anterior walls of the vagina, while the genital gap gapes.
Second degree – the pelvic floor muscles weaken more significantly, the prolapse of the vaginal walls gradually continues. This also lowers the bladder and rectum (its front wall).
Third degree – the uterus is already lowered, and its cervix is ​​at the level of the entrance to the vagina.
Fourth degree – incomplete prolapse of the uterus occurs. In this case, the cervix is ​​already outside the entrance to the vagina
Fifth degree – the woman has a complete prolapse of the uterus, during which the walls of the vagina are turned inside out. Organ prolapse occurs, as a rule, in old age.

The process of prolapse of the internal genital organs with reproductive disorders, while it is also possible:
– urinary disorder,
– difficulty in emptying the intestines,
– the appearance of frequent pain, inflammation,
– a feeling of discomfort when walking, movement, sexual intercourse.
All of the above phenomena significantly reduce the quality of life.

The danger of the problem is that at first it may not declare itself in any way. Therefore, for its prevention, you should be examined by a gynecologist at least once every 6 months.

Call a specialist immediately if you experience the following symptoms:
– sensation of a foreign body in the vagina, urinary incontinence, constipation,
– a feeling of heaviness in the lower abdomen,
– unusual vaginal discharge.

In the Genom-Don clinic, the problem of prolapse / prolapse of internal genital organs is solved in a complex, efficient and reliable way using surgical technologies.

The list of reconstructive gynecological operations includes:
– Surgical fixation of the uterus and other internal organs of the reproductive system in a normal position when they are displaced / lowered / prolapsed;
– surgical treatment to narrow the vagina;
– correction of injured perineal areas;
– improving the shape of the labia.

Descent of the pelvic organs in women Diagnosis and treatment at the KST clinic

The causes of many gynecological and urological diseases is the prolapse of the pelvic organs. From the moment of the onset of the disease to its climax – when the symptoms, figuratively speaking, “come out”, it takes more than one year. In this relatively prosperous period, women usually do not associate changes in their condition with the prolapse of the walls of the vagina and uterus, and they turn to a doctor late.

The prolapse of the pelvic organs is a condition when, against the background of the formed weakness of the ligamentous apparatus, they are displaced from their anatomical axis. Because of this, pathological sagging, protrusion and prolapse of the walls of the vagina, rectum, bladder, and uterus are formed.

Depending on which organ was displaced, characteristic complaints appear. So, if the rectal area was affected, patients complain of a loss of ability to retain feces or, conversely, constipation.If the bladder suffers, dysuric disorders appear: frequent urge to urinate, nighttime diabetes, urinary incontinence. All these conditions significantly affect both the health and the quality of life of a woman and require mandatory correction.

Pelvic organ prolapse occurs in 50% of women in adulthood and in 25% in the postpartum period. This prevalence, combined with debilitating, steadily progressive symptoms, makes the problem of genital prolapse significant.

For many decades, scientists around the world have been looking for an effective and safe way to correct prolapse. Radical surgical techniques were actively used to treat prolapse of the uterus and vagina. But this tactic was associated with significant complications and long postoperative recovery.

In our Moscow gynecological clinic, we treat all types of prolapse using laser technology and mesothreads. This method of correction gave us the opportunity to effectively and, most importantly, safely help patients to relieve them of suffering.We have so often performed within our walls the treatment of the prolapse of the pelvic organs that we can say that these procedures have become everyday and routine for us.

Causes leading to prolapse of the uterus, vagina, cervix

The position of the internal organs is maintained by ligaments consisting of dense connective tissue rich in elastin and collagen. With their imbalance, loss of elasticity and strength, their ability to hold organs in the desired position is disrupted.Even a slight prolapse or deviation of the uterus or vagina pulls along with it the displacement of all other pelvic organs in a woman.

The reasons for the development of dysfunction of the musculo-ligamentous apparatus of the perineum may be as follows:

• Dyshormonal phenomena associated with a drop in the level of estrogen in the blood. The initial forms of hypoestrogenism appear in women as early as 40-42 years. Later, closer to menopause, the amount of estrogen in the blood falls steadily. Normal muscle tone and connective tissue elasticity are maintained by estrogen.With a decrease in its production, the ability of fibroblasts to synthesize collagen, a protein that forms the basis of connective tissue and is responsible for its strength and elasticity, suffers. Ligaments stretch and sag, creating a prerequisite for the formation of genital prolapse;
• Damage to the structures of the small pelvis after childbirth, especially if they occurred with tears and injuries of the perineum, obstetric forceps and other aids were used for obstetric aid. Rupture, stretching, damage and violation of the trophism of the muscular-connective tissue often occur during multiple pregnancies in women with insulin resistance and in young women in labor.Rapid labor can also damage ligaments and tendons. Frequent delivery at short intervals also causes pathological hyperextension of the ligaments;
• diseases of internal organs leading to metabolic disorders or increased intra-abdominal pressure;
• hereditary disorders of connective tissue elasticity. In such patients, prolapse is accompanied by hernias, astigmatism, etc.

When choosing therapy and choosing treatment tactics, our gynecologists take into account the main cause of the development of the disease.If this is not done, then the likelihood of relapses is high, bringing serious discomfort to the woman.

Symptoms of pelvic organ prolapse

We can say that prolapse in women sneaks up unnoticed. At the initial stage, symptoms may be mild and irregular. During this period, a woman usually does not pay attention to them and associates what is happening with overwork, unhealthy diet, stress, etc. In a more advantageous position, those women whose culture presupposes regular preventive examination by a gynecologist.Indeed, during the simplest examination on the chair, we can already identify the problem, because it is clearly visible.

Symptoms of prolapse of the pelvic organs are as follows:

• The first complaints are usually associated with the fact that during intimacy a woman feels unpleasant and often painful sensations in the perineum. The quality of sexual relations changes. In medicine, this condition is called “Dyspareunia”. To identify it, we use special questionnaires, as we noticed that at the reception you are embarrassed to talk about this problem even with us, gynecologists.
• Frequent, unreasonable urge to urinate, nocturnal diabetes, urinary disturbance, feeling of incomplete emptying of the bladder – all these dysuric disorders can result from prolapse of the uterus and vagina. If you do not provide help in time, the most striking symptom of failure of the ligamentous apparatus of the pelvis gradually develops – urinary incontinence syndrome.
• Stress urinary incontinence syndrome is the most common manifestation of prolapse. In this state, there is an involuntary leakage of urine droplets when laughing, sneezing, during intercourse, having sex and other conditions that cause a sharp change in intra-abdominal pressure.If you do not start treatment, then in addition to general disharmony and the formation of a feeling of inferiority, there is a high probability of bacterial contamination of the uro-genital area with the development of cystitis and urethritis.
• Another symptom. indicative of prolapse of the vagina and uterus, there may be recurrent cystitis. We ask our colleagues, urologists, to remember this factor, because you will come to them first.

• In the case when the uterus and vaginal wall protrudes towards the rectum, complaints about the act of defecation appear.Such women often find themselves in an awkward state associated with not having time to run to the toilet when they have the urge to empty their bowels.
• If, against the background of prolapse, rectal atony is formed, then in these cases we hear complaints of frequent constipation. Sometimes even at a loss on their own, without the help of mechanical means, to empty the intestines.
• With significant prolapse of the uterus and vagina, pulling pains appear in the perineal region, sometimes radiating along the inner surface of the thigh.Feeling of a foreign body in the vagina, aggravated by walking and changing body position.
• Chronic pelvic pain syndrome can also occur due to displacement and prolapse of the uterus, when pain is concentrated in the coccyx and becomes constant.

Pelvic floor prolapse detection

No complicated examination is required to diagnose pelvic organ prolapse. In most cases, prolapse is visible visually.

We carry out the Valsalva test to reveal latent forms.Its meaning is simple. During the examination on the chair, we ask the woman to strain. With the failure of the ligamentous apparatus, involuntary leakage of urine droplets is visible.

To determine the strength of the pelvic floor muscles, we use a perineometer apparatus. With its help, the disease is determined at the initial stage and the quality of treatment is assessed.

• Ultrasound of the pelvic organs is mandatory. In addition to identifying the degree of prolapse, the study provides an assessment of the condition of the uterus, its appendages, urethra and bladder;
• Magnetic resonance imaging may be prescribed for severe pelvic symptoms to confirm the diagnosis and rule out neoplastic processes.

After the examination, the results are interpreted by our gynecologists. In difficult cases, a consultation with several gynecologists and a urologist may be required.

How to treat pelvic floor prolapse?

In the KST clinic, it is customary to take a comprehensive approach to the treatment of pelvic organ prolapse in women. For mild prolapse, we recommend:

• lifestyle change, especially elimination of hypodynamia.
• If you are overweight, we will try to normalize your weight and eliminate hidden signs of insulin resistance.
• If a woman is actively involved in sports, then we will recommend reducing the intensity of training. Especially in those exercises in which intra-abdominal pressure increases;

We teach 90,108 all patients exercises to strengthen the muscles of the pelvic floor. Exercises to strengthen the pelvic corset are required to be performed regularly. They are based on sequential contraction and relaxation of the perineal musculature.

• Strengthening the pelvic floor with mesothreads based on hyaluronic acid is able to permanently strengthen the pelvic diaphragm and delay the progression of the disease.This painless and effective procedure with a pronounced additional cosmetic effect is very much loved by our patients.

For high-grade prolapse, we recommend more effective treatments. In our clinic, we use laser technology to treat the prolapse of the pelvic organs.

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Laser treatment of prolapse

In our Clinic of Modern Technologies for the treatment of involutional changes, we use the innovative CO2 laser Eraser-C.Such equipment favorably distinguishes us from other gynecological clinics in Moscow.

An individual course of laser therapy is selected for each woman, depending on the degree of prolapse, the state of the mucous membrane and the presence of concomitant diseases. Usually, three procedures are sufficient with an interval of one month between them.

Each treatment procedure begins with a laser setting. The doctor selects the parameters of laser radiation and the duration of exposure. Before manipulation, an anesthetic cream is applied to the external genitals.Ten minutes after the cream has been absorbed, the treatment can begin. On average, a session lasts 20-25 minutes and is easily tolerated by women.

How is laser treatment carried out? The gynecologist directs the laser beam to the problem area, microcracks form in the tissues under the influence of thermal energy. After the procedure, these zones will experience enhanced regeneration and stimulation of collagen production, which is so necessary for strengthening the tissues. The formation of connective tissue increases, its fibers become larger and shorter.The sagging zone is tightened and strengthened.

Advantages of method

The success of the treatment of pelvic organ prolapse using a CO2 laser has been confirmed by numerous randomized studies conducted both in our country and abroad. The method was so fond of and took root in gynecology that loving CO2 laser began to be called a “workhorse”. This is due to several reasons:

• 2-3 laser treatments have a lasting and significant effect.
• the disappearance of prolapse symptoms occurs after the first session;
• does not require lengthy preparation for the intervention.
• The recovery period with this method of exposure is short, without limiting the ability to work.
• at the end of the procedure, the woman can go home, since medical supervision is not required;
• , subject to contraindications, patients have no complications.
• due to the effect at the micro level, the technique is completely painless and safe;
• sustained improvement in the quality of life;
• Visible cosmetic effect and improvement of the vaginal mucosa.

Our Moscow Gynecological Clinic of Modern Technologies has been accepting women in need of gynecological examinations and treatment for 24 years already. Within our walls you will find academically competent specialists with extensive experience and experience.

Physicians specializing in correcting prolapse of the pelvic organs:

Cost

• Treatment of vaginal relaxation syndrome 19,000
• Laser treatment of prolapse of the anterior vaginal wall (1 procedure) 19 000
• Laser treatment of urinary incontinence (1 procedure) 17,000
• Laser treatment of atrophy of the vaginal walls Category 1 12,000
• Laser treatment of atrophy of the walls of the vagina and vulva, category 2 17,000
• Intimate lifting with mesothreads
• Intradermal intimate contour plasty with mesothreads 1 thread 470
• Narrowing of the vaginal opening with mesothreads (20 threads) 9 400
• Lift (lifting) of the labia majora with mesothreads (30 threads) 16,000
• Correction of perineal asymmetry (20 threads) 9000
• Correction of perineal asymmetry (30 threads) 18,000

90,000 Mitral valve prolapse: what it is, how to diagnose

Mitral valve prolapse is a defect that is considered one of the most common in people suffering from heart problems.According to statistics, every fifth person lives with prolapse. It does not often cause complications, so many people may be unaware of their diagnosis all their lives. However, is mitral valve prolapse actually harmless?

Mitral valve prolapse: what is the diagnosis?

MVP (mitral valve prolapse) is a pathological change in the mitral valve, in which one or both of its valves bulge or sag into the atrial cavity during the contraction of the ventricle.MVP occurs in people of all ages and different sexes, but at the same time, women suffer from it much more often than representatives of the stronger sex.

Prolapse can be primary and secondary – depending on developmental factors. If the prolapse is caused by a congenital malformation of the connective tissues, exposure of the fetus in the womb to toxic substances, or is a hereditary factor, then it is considered primary. Secondary (acquired) prolapse is a consequence of chest injuries, inflammation, rheumatism, etc.d.

In addition, the factors provoking secondary MVP include:

• Ischemic disease.
• Vegetative dysfunction of the cardiovascular system.
• Ventricular wall hypertrophy.
• Insufficient blood supply to the papillary muscles.

The disease has three degrees (ultrasound of the heart can determine them). At grade 1, the valve sags into the atrial cavity by less than 5 mm. At the 2nd degree, valve prolapse up to 10 mm is noted.If the flaps sag by more than 10 mm, this is the 3rd degree of MVP.

Many patients are sure that with such a diagnosis nothing needs to be done, because many live peacefully with him all their lives. However, MVP can provoke serious complications and even lead to death.

The most common complication of MVP, which occurs in 80% of people with prolapse, is cardiac arrhythmias.

In addition, the following sad consequences are possible:

• Insufficiency of the mitral valve.
• Infectious myocarditis (inflammation of the myocardium).
• Ischemic stroke.
• Cerebrovascular diseases (pathological changes in blood vessels with impaired blood circulation in the brain).
• Rupture of the tendon chord or separation of the chords from the papillary muscles.
• Sudden coronary death.

Therefore, in no case should the diagnosis of MVP be neglected!

Signs of mitral valve prolapse

When the disease is congenital, that is, MVP is primary, then it often proceeds without visible symptoms.

In other cases, signs of MVP can be:

• Failures of the heart rhythm (the heart periodically freezes, the heartbeats become irregular).
• Pain in the region of the heart, which occurs not after physical activity, but after emotional upheavals (cannot be stopped by nitroglycerin, but can last as long as a few seconds or several hours).
• Inability to inhale deeply, constant suffocation.
• Increased fatigue, exercise intolerance.
• Headaches, dizziness, systematic fainting.
• Panic attacks.

Diagnosis of mitral valve prolapse

As a primary diagnosis, a cardiologist will analyze the patient’s anamnesis, listen to his complaints, send him for a blood test (general and biochemistry).

Instrumental diagnostic methods are also required:

• Ultrasound of the heart (also called EchoCG – echocardiography).
• ECG (electrocardiography).
• MRI of the chest.

Ultrasound of the heart in our time is the simplest, most accessible and at the same time the most informative method for diagnosing MVP. It will help to detect not only the sagging of the mitral valve leaflets, but also their thickening, expansion of the mitral annulus, lengthening of chords, hypertrophy of the heart sections.

With the examination results, be sure to contact a cardiologist to prescribe a treatment regimen. This diagnosis is not a verdict at all, but it should not be ignored either.By the way, a healthy lifestyle together with treatment helps to successfully maintain the quality of life. Take good care of your health!

90,000 Uterine prolapse (genital prolapse)

• Accurate determination of the severity of the problem – any diagnosis.

• Conservative treatment for minor prolapse: electrical stimulation, laser therapy.

• Minimally invasive surgery for severe prolapse: operations with vaginal and laparoscopic access, on a new generation Da Vinci robot.

Genital prolapse ( uterine prolapse ) – a condition characterized by prolapse of the female genital organs (walls of the vagina, uterus and cervix). With severe prolapse, there may be prolapse of the bladder and rectum. A problem arises due to weakening or stretching of the muscles and ligaments of the pelvic floor. The prolapse of the uterus can occur in a woman at any age.

Symptoms of prolapse of the uterus

The initial stages of genital prolapse are asymptomatic, so they can only be detected by examination by a doctor and by conducting special tests.Over time, the prolapse of the genitals inevitably progresses. In this regard, it is important to identify the disease in time and start treatment.

With the progression of uterine prolapse, one or more symptoms may appear and increase:

• heaviness in the pelvic region;

• pain during sexual intercourse;

• frequent urination, urinary incontinence when urging / coughing / sneezing / jumping;

• difficulty urinating;

• incontinence or stool retention;

• discomfort in the perineal region while sitting, while walking.

Consequences of genital prolapse

If measures are not taken in a timely manner, the following may occur:

• prolapse of the cervix and uterus;

• eversion of the walls of the vagina, intestines and bladder;

• bowel dysfunction;

• inflammation of the vagina and uterus;

• significant deterioration in the quality of sexual life.

Causes of prolapse of the uterus

Among the risk factors for the formation of prolapse:

• two or more genera, difficult childbirth;

• postmenopausal;

• regular weight lifting;

• chronic constipation, chronic cough, weight gain.

Diagnosis of prolapse of the uterus

Diagnosis of genital prolapse is carried out by a gynecologist.

Since every third woman’s prolapse is accompanied by urinary disorders, to determine the severity of the problem and its solution at the EMC Gynecology and Oncogynecology Clinic, patients undergo a urodynamic study (UDI) using Laborie equipment. It is this equipment that is used for conducting KUDI in leading medical clinics in the USA and Europe.

Prolapse treatment

Conservative treatment

At the initial stages of genital prolapse, specialists prescribe conservative treatment to strengthen the pelvic floor muscles and painless electrical stimulation.These techniques prevent disease progression.

With a slight prolapse of the uterus, EMC gynecologists use an effective non-surgical method of treatment – fractional photothermolysis (laser therapy).

Laser beams, acting on the tissues of the vagina, trigger the natural process of collagen and elastin production, improve the innervation and blood flow of the mucous membranes. The result is a narrowing of the vagina, increasing its firmness and elasticity.

Laser therapy is also very effective in preventing prolapse (especially after childbirth and postmenopausal women).

Photothermolysis is often used after surgical treatment of prolapse to increase the sensitivity of the vagina.

Benefits of photothermolysis:

• Efficiency. To achieve the desired effect, you need from 1 to 4 procedures, depending on the severity of symptoms and the initial state of the tissues.

• Painlessness. As a rule, anesthesia is not required for photothermolysis. In some cases, it is possible to carry out the procedure with local anesthesia.

• Lack of rehabilitation. The woman can leave the clinic immediately after the end of the procedure. It is possible to resume sexual activity one day after laser treatment.

If necessary, a pessary is selected and installed – a special device that supports the uterus. This non-surgical method of treating genital prolapse is recommended when surgery is contraindicated or undesirable.

Surgical treatment

The surgeons of the EMC Gynecology Clinic have extensive experience in performing a full range of reconstructive pelvic minimally invasive operations for genital prolapse and stress urinary incontinence in women.

In case of severe prolapse, EMC specialists perform surgical intervention. The essence of the operation is to strengthen the damaged ligaments that hold the female genital organs, bladder and rectum, in combination with excision of excess overstretched tissue.

Most of these manipulations are performed by vaginal access without incisions on the abdomen, so women quickly recover from surgeries.

EMC gynecologists also perform modern laparoscopic procedures, during which specialists lift the pelvic organs with mesh implants (sacrocolpopexy).Most of these operations are carried out using the new generation Da Vinci robot.

If prolapse is accompanied by stress urinary incontinence, EMC gynecological surgeons perform a sling operation to treat urination as part of the prolapse intervention. During such an operation, a special tape (sling) is placed on the patient to support the urethra. The woman does not feel the installed sling.

Elderly patients who do not want a major pelvic reconstructive surgery can undergo Lefort’s unique sparing surgery at EMC.

Advantages of contacting EMC

• Doctors with experience in leading clinics in the USA and Europe. Modern international protocols for diagnosis and treatment.