Vaginal prolapse, also known as a vaginal hernia, is when the vagina slips out of place in the body. Sometimes the vagina moves only slightly, or it can move significantly. In the most severe cases, it can protrude from the body. Vaginal prolapse can cause discomfort, but can be treated with vaginal physical therapy, medication, or surgery if necessary.
This article discusses the signs, causes, and treatment of vaginal prolapse.
Signs and symptoms of vaginal prolapse
Many women do not have any symptoms of vaginal prolapse. A healthcare provider may find it during a gynecological exam. Women with signs and symptoms may have:
- Feeling of fullness or gas (may be more pronounced when coughing, lifting something, or near the end of the day)
- lower back pain
- Urine leakage
- bladder infection
- Difficulty defecation
- discomfort during sex
- Difficulty inserting tampons
In severe cases, the organ may protrude from the vaginal opening.
Who is most likely to have vaginal prolapse?
Vaginal prolapse is more common in women with:
- have delivered several children vaginally
- older or postmenopausal
- have obesity
Types of vaginal prolapse
There are two types of vaginal prolapse, categorized by the degree of vaginal movement.
When the prolapse is small and the vagina descends only part of the vaginal canal, it is called incomplete prolapse. Larger prolapses are called complete prolapses, in which some vaginal tissue can protrude from the body.
Prolapses are also classified by affected organs:
- cystocele: Prolapse of the bladder due to prolapse of the anterior vaginal wall (if the urethra also prolapses, it is called cystourethral bulge)
- rectocele: Rectal fall due to prolapse of the posterior vaginal wall
- enterocele: Small intestinal hernia due to diminished vaginal support, sometimes due to hysterectomy
- uterine prolapse: Due to weak ligaments at the top of the vagina
Causes of vaginal prolapse
As many as one-third of women will experience some kind of vaginal prolapse at some point in their lives. The most common reasons are:
- Vaginal birth, especially multiple births
- after hysterectomy
- nervousness from lifting heavy objects or having a bowel movement
There are other rare diseases, such as tumors or congenital bladder disease, that can cause prolapse.
How is vaginal prolapse diagnosed?
A healthcare provider diagnoses vaginal prolapse through a physical exam. They may ask you to move your muscles like you have a bowel movement or stop urinating.
They will also ask about any symptoms you may be experiencing, such as incontinence.
If complete prolapse is suspected, they may order imaging tests, such as an ultrasound, to see how the prolapse is affecting or being affected by other organs.
Treatment and Prevention of Vaginal Prolapse
If the prolapse is mild and you have no symptoms, you may not need treatment. If discomfort is caused, treatment includes:
- Vaginal physical therapy for mild vaginal prolapse or general pelvic floor prolapse. This therapy can include Kegel exercises.
- Fits a pessary, a small device inserted into the vagina to provide support.
- Surgery, usually minimally invasive, is used to repair weak structures and add support. Surgeons can also suture the vagina, which stops symptoms, but you can no longer penetrate fully during intercourse.
You can help prevent prolapse by:
- do kegel exercises
- maintain a healthy weight
- do not smoke
- Use your leg muscles to help you lift and lower heavy objects
Vaginal prolapse is a condition in which the vagina slips out of the body. It is more common in women who have delivered several children vaginally and in older postmenopausal women. Vaginal prolapse may not cause any symptoms, but if it occurs, physical therapy and possibly surgery (if the prolapse is severe) can strengthen the pelvic muscles and help support the vagina.
Vaginal prolapse can cause discomfort. If you notice a heavy feeling, or if you are sitting on something raised, you may be prolapsed. If you develop symptoms, contact your healthcare provider or gynecologist for treatment.
Frequently Asked Questions
How do you know if you have prolapse?
You may prolapse if you feel stressed, such as when you may be sitting on something raised, or if you feel heavy or full. A healthcare provider can diagnose you and treat the prolapse if you need it.
What happens if the prolapse is not treated?
Most prolapses do not require treatment or respond well to treatment. Prolapse may recur after surgery, but it is unlikely.
Can you fix prolapse yourself?
Pelvic muscle exercises can help strengthen the muscles that support the vagina. Let a professional show you how to do them properly and how often.
How do I know if my prolapse is serious?
If you have trouble having a bowel movement or urination, or if you notice protruding tissue in your vagina, you may have a severe prolapse that usually responds well to treatment.