Utero-vaginal prolapse is a prolapse of womb and vaginal walls. Firstly, uterine prolapse symptoms may be absent. Utero-vaginal prolapse treatment may include conservative methods (exercises, devices) and surgical (interventional procedure). Below we will discuss in detail causes of uterine prolapse and its treatment options.
When there is protrusion of an organ or structure beyond its normal position, a prolapse occurs. In this condition, the uterus and/or vagina is descended. Even though, this is a common gynecological condition, many women do not seek treatment due to embarrassment or they are unaware that the condition can cause problems and that treatment is available. It’s crucial to seek medical advice early as it can be treated. This condition occurs on its own but may also be associated with a protrusion of the anterior (front), or posterior (back) wall of the vagina, or both.
Women who have had their uterus removed may experience a prolapse of the vagina after surgery. The degree of the prolapse may vary from a very mild descent of the pelvic organs to a severe descent where the uterus, part of the bladder and part of the rectum (back passage) protrudes through the vaginal opening.
WHAT CAUSES UTERO-VAGINAL PROLAPSE?
Weakness in the supporting tissues of the uterus and vagina causes the prolapse. Common factors leading to this are:
- Pregnancy & Childbirth: Excessive stretching of the tissues
- After menopause: Lack of female hormones can lead to thinning and weakening of the tissues
Additionally, any condition that leads to an increase in the pressure in the abdominal cavity (chronic cough, constipation or heavy lifting) can aggravate the prolapse.
UTERINE PROLAPSE SYMPTOMS
Women with a very mild degree of prolapse may not have any symptoms at all. Most women with the condition have a significant prolapse and may experience some of the followings:
- Dragging sensation or discomfort in the lower abdomen or pelvis
- Sensation of swelling or fullness in the vagina
- Sensation of incomplete emptying of the bladder
- Leakage of urine during coughing, sneezing and straining
- Vaginal discharge or bleeding
- Difficulty in passing motion or urine
- Passing urine more frequently
UTERO-VAGINAL PROLAPSE TREATMENT OPTIONS
This is a device that fits inside your vagina to hold your uterus in place. It is a temporary or permanent treatment. They come in many different shapes and sizes. Your doctor will measure and fit you for the proper device. You’ll be taught on how to insert, remove and clean the pessary. You may be able to take the pessary out overnight and reinsert it each day; while other pessaries can be left in place for longer periods of time.
This device may be of little use if you have severe uterine prolapse. A pessary may also irritate vaginal tissues, possibly to the point of causing sores on vaginal tissues and it may interfere with sexual intercourse.
Your surgeon may perform the procedure through your vagina to repair damaged or weakened pelvic floor tissues, although sometimes an abdominal surgery is needed. Surgery may involve grafting your own tissue, donor tissue or some synthetic material onto weakened pelvic floor structures to support your pelvic organs. A hysterectomy (removal of uterus) may be recommended.
Minimally invasive (laparoscopic) surgery is a possibility in some cases. Smaller abdominal incisions, special surgical instruments and a lighted camera-type device (laparoscope) are used to guide the surgeon.
The type of surgery and surgical approach your doctor may recommend depends on individual needs and circumstances. Each procedure has pros and cons that you’ll need to discuss with your surgeon.
LASER VAGINAL REJUVENATION (LVR)
This procedure is performed to tighten and narrow the vagina. This is to increase sexual gratification in women who feel that their vagina is too loose after repeated intercourse or child bearing.
DIAGNOSING UTERO-VAGINAL PROLAPSE
- History taking: Questions will be asked in order to assess how uterine prolapse has affected your quality of life. This information helps to determine treatment decisions.
- Pelvic exam: You may be asked to bear down as if having a bowel movement. This allows your doctor to assess how far the uterus has slipped into your vagina. Your doctor may ask you to tighten (contract) your pelvic muscles, as if you’re stopping the stream of urine to check the strength. Examination can be conducted while lying down and while standing up.