Prolapse

Vaginal prolapse occurs the womb or vaginal walls drop-down or sags down. Most prolapses are mild and do not require any intervention apart from physiotherapy. Treatment is only offered to those where the prolapse is large or symptomatic in spite of physiotherapy.

Types of Prolapses

Cystocele
When the bladder support fails, the front wall of the vagina bulges.

Rectocele
This occurs when the rectum bulges through the posterior wall of the vagina.

Uterine Prolapse
This occurs when the womb's structural supports fail, allowing it to drop into the vagina.

Vault prolapse
When the top of the vagina drops or sags following a hysterectomy.

Causes of Prolapse

Age and menopause
There is an increased chance of prolapse as the flexibility of our tissues diminishes. Low amounts of oestrogen also weaken tissues and impair their elasticity after menopause.

Pregnancy
This puts undue strain on the vaginal and uterine ligaments and supports.

Caesareans
Prolapse and incontinence are not prevented by caesarean sections, although a protracted, difficult, or traumatic vaginal delivery increases the risk.

Genetic factors
It's possible that prolapse runs in families. Joint hypermobility syndrome, Ehlers-Danlos syndrome, and Marfan's syndrome increase prolapse risk.

Chronic constipation with obesity
Because of the increased pressure, these patients are likely to have more chances of prolapse

Tumours of the pelvis
Extra pelvic pressure, such as that caused by fibroids or ovarian cysts, increases the risk of prolapse.

The nature of the job
A prolapse might be exacerbated by work that requires a lot of lifting.

Straining
Women who have a chronic cough or constipation are at greater risk of prolapse.

Symptoms of Prolapse

  • There may be dragging or heaviness in the vagina if it is prolapsed.
  • Pelvic pressure is felt as a result of being overstuffed.
  • Painful sex

Urinary symptoms:

  • Incontinence and the urgency to pass urine
  • Increased frequency of urination
  • Incomplete emptying of the bladder

Bowel symptoms:

  • Constipation
  • Need to support the back passage

Prevention

Prolapse is a condition that can be prevented by a variety of measures, including consistent pelvic floor training and a healthy weight are both important. Dieting high in fibre, quitting smoking, and limiting heavy lifting are all ways to reduce the occurrence of prolapse.

Helpful links

https://www.nhs.uk/conditions/pelvic-organ-prolapse/