Vaginal Prolapse Symptoms, Causes, Treatment, and Surgery Repair

The network of muscles, ligaments, and skin in and around a woman's vagina acts as a complex support structure that holds pelvic organs, and tissues in place. This support network includes the skin and muscles of the vaginal walls (a network of tissues called the fascia). Various parts of this support system may eventually weaken or break, causing a common condition called vaginal prolapse.

Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions. Without medical treatment or surgery, these structures may eventually prolapse farther and farther into the vagina or even through the vaginal opening if their supports weaken enough.

The symptoms that result from vaginal prolapse commonly affect sexual function as well as bodily functions such as urination and defecation. Pelvic pressure and discomfort are also common symptoms.

Symptoms most commonly associated with a vaginal prolapse depend on the type of vaginal prolapse present. The most common symptom of all types of vaginal prolapse is the sensation that tissues or structures in the vagina are out of place. Some women describe the feeling as "something coming down" or as a dragging sensation. This may involve a protrusion or pressure in the area of the sensation. Generally, the more advanced the prolapse, the more severe the symptoms.

General symptoms that may be seen with of all types of vaginal prolapse include pressure in the vagina or pelvis, painful intercourse (dyspareunia), a mass at the opening of the vagina, a decrease in pain or pressure when the woman lies down, and recurrent urinary tract infections.

Symptoms specific to certain types of vaginal prolapse include:

• Difficulty emptying bowel: This may be indicative of an enterocele, vaginal vault prolapse, or rectocele. A woman with difficulty emptying her bowel may find that she needs to place her fingers on the back wall of the vagina to help evacuate her bowel completely. This is referred to as splinting.
• Difficulty emptying bladder: This may be secondary to a cystocele, urethrocele, enterocele, vaginal vault prolapse, or prolapsed uterus.
• Constipation: This is the most common symptom of a rectocele.

A network of muscles provides the main support for the pelvic viscera (the vagina and the surrounding tissues and organs within the pelvis). The major part of this network of muscles, which is located below most of the pelvic organs and supports the organs' weight, is called the levator ani. Pelvic ligaments provide additional stabilizing support.

When parts of this support network are weakened or damaged, the vagina and surrounding structures may lose some or all of the support that holds them in place. Collectively, this condition is called pelvic relaxation. A vaginal prolapse occurs when the weight-bearing or stabilizing structures that keep the vagina in place weaken or deteriorate. This may cause the supports for the rectum, bladder, uterus, small bladder, urethra, or a combination of them to become less stable.

Journal of Women’s Health and Reproductive Medicine is an interdisciplinary journal that explores clinical, medical, social and economic aspects of female reproductive health and medication worldwide.

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John Kimberly
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Journal of Women’s Health and Reproductive Medicine
Email: womenshealth@emedscholar.com