Vaginal Prolapse

There are many different types of vaginal prolapse, including:

• Vaginal Vault Prolapse – When the top of the vagina collapses into the vaginal canal.
• Anterior Prolapse (Cystocele) – When the bladder bulges into the vaginal space.
• Urethrocele – When the urethra sags or presses into the vagina.
• Posterior Vaginal Prolapse (Rectocele) – when the thin wall separating the rectum and the vagina weakens, allowing the vaginal wall to bulge.
• Enterocele – When the small intestine drops (prolapses) causing a bulge in the vagina.
• Uterine Prolapse – When the the uterus drops down into the vagina.

Vaginal Prolapse is a relatively common problem for women. Over 1/3 of women experience some form of Pelvic Organ Prolapse in their lifetime. The risk of prolapse increases with age and other factors including regular smoking, high weight, etc.

Many women with Vaginal Prolapse experience no symptoms at all. Often, you will only find out that you have Vaginal Prolapse during routine health checks and examinations. However, some common symptoms of Vaginal Prolapse include:

• Bulging in the vagina (caused by prolapsing pelvic organs)
• Organs slipping out of the vagina
• Problems/pain during sexual intercourse
• Urinary incontinence (uncontrolled urination/bladder leakage)
• Heaviness or pain in the pelvic area. This can become increasingly worse throughout the day, especially following prolonged standing, heavy lifting or coughing.
• Bladder infections
• Difficulty passing bowel movements
• Difficulty using/inserting tampons

Vaginal prolapse is a condition where the vagina slips out of position. Pelvic organ prolapse happens because the muscles and ligaments supporting and holding these organs in their correct positions become weakened.

Causes of Vaginal Prolapse include:

• Childbirth: Vaginal delivery increases the risk of prolapse more than a cesarean section. The risk of prolapse is also increased the more children a woman delivers, as well as with the delivery of a large baby (more than 9 pounds).
• Surgery: Other surgical procedures, such as a hysterectomy, or radiation treatment in the pelvic area, can cause a prolapse.
• Menopause: During menopause, the production of the hormone estrogen is reduced. Estrogen is particularly important because it helps to strengthen your pelvic muscles. During menopause, pelvic muscles can become weak and a prolapse can develop.
• Aging: Older women are at a higher risk of developing a prolapse.
• Activity/Lifting: Excessive Strain from overly heavy lifting or strenuous activity can weaken the pelvic muscles and increase the risk of prolapse.
• Genetic Factors: Genetic factors can mean that you may be at increased risk of a prolapse.

Other factors which can contribute to Vaginal Prolapse:

• Smoking: Smoking can cause chronic coughing which places increase pressure on the pelvic area
• Being Overweight
• Excessive Straining During Bowel Movements

We highly recommend expert diagnosis and advice for all symptoms and potential problems. Diagnosis for prolapse will include a physical exam, as well as a discussion of your symptoms and medical history.

Well Woman Clinic always puts the patient first. We’re here to listen to your concerns and help to reassure you. When you book with Well Woman Clinic, you skip the long wait times of the NHS and gain direct access to the UK’s leading consultants.

Vaginal Prolapse treatment varies depending on the severity of your prolapse. Sometimes, your specialist will just need to monitor your prolapse regularly to ensure it does not get worse.

Vaginal Prolapses can be treated both surgically and non-surgically. Your specialist will take into account numerous factors when deciding on the best treatment for you, including:

• Your overall health and whether you have any other significant medical conditions.
• How old you are.
• How severe your prolapse is.
• Whether you wish to have children in the future.
• If you want to continue having/be able to have penetrative sex in the future.

Please ensure you are honest when talking with your specialist. Some of the treatments for Vaginal Prolapse can mean you will be unable to have sexual intercourse or have more children. Make sure you discuss any concerns with your specialist prior to treatment.

Non-surgical treatments are preferred by our specialists due to their non-invasive nature. However, these often only work with very minor prolapses. Some non-surgical treatments include:

• Exercise: Your pelvic muscles can be strengthened with kegel exercises, helping to reduce the extent of vaginal prolapse. To perform 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. For more information please click here.
• Vaginal pessary: A pessary is a plastic or rubber support which helps to hold things in place. A pessary will be fitted by your specialist. It needs to be cleaned frequently and removed before sexual intercourse.

Although non-surgical treatments are often preferred, you may require surgical treatment for effective results. These include:

• Vaginal or laparoscopic assisted vaginal hysterectomy: Surgical removal of the uterus to treat prolapse of the uterus (uterine prolapse) – this will remove your ability to get pregnant.
• Laparoscopic sacrohysteropexy: This operation corrects uterine prolapse. It is often chosen by patients who do not wish to have hysterectomy. It can be carried out using keyhole (laparoscopic) approach under general anaesthesia. Associated prolapse of the vagina is dealt with at the same time.
• Sacrocolpopexy: This procedure involves attaching your vagina to your tailbone with mesh to give the vagina a lift. This surgery is done with laparoscopy.
• Sacrospinous fixation: A sacrospinous fixation involves supporting the vaginal vault using stitches to fix it to a strong ligament inside the pelvis.
• Colpocleisis for vault prolapse: Colpocleisis is a procedure involving closure of the vagina. It is used to treat vaginal prolapse. In older women who are no longer sexually active a simple procedure for reducing prolapse is a partial colpocleisis.

Unfortunately, vaginal prolapse often cannot be prevented. However, you can reduce your risk of vaginal prolapse by following healthy lifestyle habits, including:

• Performing kegel exercises regularly: For more information, click here.
• Maintaining a healthy weight and diet.
• Quitting smoking.
• Avoiding heavy lifting without using correct technique.

Vaginal prolapse can reoccur after treatment, but our specialists will ensure you receive the best treatment plan for you. Prolapse is much less likely to reoccur following surgical treatment.