All about vaginal prolapse

Vaginal prolapse is a medical condition that many women may encounter during their lives.

Here, Mr Alasdair Duncan Gordon, renowned consultant obstetrician and gynaecologist, offers his expert insight into vaginal prolapse and how it can be treated.

What is vaginal prolapse?

Vaginal prolapse, also known as pelvic organ prolapse, is a condition that occurs when the pelvic floor muscles become weak or damaged, leading to the descent of pelvic organs into the vaginal canal.

Common symptoms include:

• a feeling of pressure or fullness in the vagina
• tissue protruding from the vagina
• difficulty or pain during sexual intercourse
• incomplete emptying of the bladder or bowel
• frequent urinary tract infections
• backache or pelvic pain

Vaginal prolapse is more common in older women, but it can affect women of any age.

What are the common causes of vaginal prolapse?

Vaginal prolapse occurs when the structures that support the uterus, bladder, or rectum weaken, causing them to drop or press into the vagina.

Common causes include:

• Childbirth: The strain on pelvic floor muscles and tissues during childbirth, especially during multiple pregnancies or vaginal deliveries, can stretch and weaken the pelvic floor. Women who have had multiple vaginal deliveries or large babies are at a higher risk.
• Ageing: The natural ageing process can lead to a gradual weakening of the pelvic floor muscles and tissues.
• Chronic constipation: Straining during bowel movements over an extended period can put stress on pelvic muscles.
• Obesity: Excess body weight can increase pressure on the pelvic organs, contributing to prolapse.

What impact can hormonal changes, such as the menopause, have on vaginal prolapse?

Hormonal changes, such as those associated with the menopause, can affect the elasticity and strength of pelvic tissues. The decline in oestrogen levels during the menopause can contribute to the onset or worsening of vaginal prolapse. Hormone replacement therapy (HRT) may be recommended in some cases to alleviate symptoms and support pelvic tissue health.

How is vaginal prolapse treated?

Various treatment options are available for managing vaginal prolapse, ranging from non-surgical approaches to surgical interventions.

Non-surgical approaches

• Pelvic floor exercises (Kegels): These exercises strengthen the pelvic floor muscles, providing better support to the pelvic organs.
• Lifestyle modifications: Maintaining a healthy weight and avoiding constipation can help manage and prevent vaginal prolapse.
• Pessaries: These are devices which are inserted into the vagina to support the displaced organs and alleviate symptoms.

Surgical interventions

Surgery for vaginal prolapse is typically considered when non-surgical interventions prove insufficient or if the prolapse is severe and significantly impacts a woman's quality of life.

• Anterior or posterior repair: This involves repairing the front (anterior) or back (posterior) vaginal walls to provide additional support.
• Hysterectomy: A hysterectomy involves the removal of the uterus, especially if it is contributing to the prolapse.
• Mesh or graft surgery: This involves using synthetic or biological materials to reinforce the pelvic floor.

The specific procedure chosen will depend on the type and severity of the vaginal prolapse.

How long is the recovery period after treatment for vaginal prolapse?

The recovery period after treatment for vaginal prolapse can vary depending on the type of treatment received and individual factors.

Non-surgical approaches typically involve ongoing self-management. Patients may start seeing improvements in symptoms with consistent efforts in pelvic floor exercises and lifestyle modifications, while pessaries usually provide immediate relief.

Recovery times for surgical interventions can vary depending on the complexity of the surgery, the individual's health, and the specific procedure performed. Minimally invasive procedures often have shorter recovery periods compared to traditional open surgeries.

To schedule an appointment with Mr Alasdair Duncan Gordon, head on over to his Top Doctors profile today.