The pelvic organs of a woman are held in place by muscles, tissue and ligaments. With age, after childbirth, and for a number of other reasons, these tissues weaken and can no longer maintain the vagina and internal organs in the correct position.
Approximately 45% of women aged 40 to 80 years experience this problem. The prolapse and prolapse of the vagina is characterized by a change in its position due to protrusion of the walls. Often, in advanced cases, vaginal prolapse is accompanied by prolapse of the bladder, rectum or uterus.
Causes
Vaginal prolapse occurs due to weakening of the muscles and ligaments that fix the organs of the pelvis of a woman. The causes of vaginal prolapse include:
- advanced age;
- long, difficult or rapid childbirth, accompanied by ruptures of the perineum;
- multiple pregnancy;
- the birth of a large child;
- changes caused by menopause due to decreased levels of the hormone estrogen;
- overweight or obesity;
- pelvic surgery;
- weight lifting;
- prolonged cough, for example, when smoking or SARS;
- persistent constipation;
- professional activity requiring a long stay on your feet.
Sometimes tissues in a woman’s body can be weakened by nature. As a result, the risk of vaginal prolapse is much increased. These cases include:
- hypermobility syndrome, in which the joints are too flexible and mobile;
- Marfan syndrome is expressed in connective tissue pathology;
- Ehlers-Danlos syndrome is characterized by hyperelasticity of the skin.
Symptoms
At the initial stage, vaginal prolapse can be asymptomatic. This problem can be detected by a gynecologist at the next examination or during an ultrasound examination.
However, most often, most women with prolapse experience unpleasant or painful sensations.
Vaginal prolapse can be accompanied not only by protrusion of its walls, but also by prolapse of the bladder, uterus or rectum. In addition to the symptoms described above, a woman may suffer from incontinence when a small amount of urine is released involuntarily during coughing, sneezing, or exercise.
The following signs of vaginal prolapse are shared:
- a feeling of heaviness or constriction;
- discomfort when walking;
- pressure in the vagina;
- pain and pressure in the lower back;
- prolapse of the uterus, bladder or rectum into the vagina;
- pain during intercourse;
- constipation or difficulty defecating;
- painful urination or defecation;
- stress urinary incontinence;
- sudden urination;
- recurrent urinary tract infections.
Thus, with organ prolapse, the woman's quality of life deteriorates, the physiological processes are disrupted, sex causes discomfort and pain.
A clear photo of vaginal prolapse can be seen below.
Varieties
To make a diagnosis, a specialist needs to conduct an internal examination of a woman. The first degree of prolapse is characterized by prolapse of the anterior, posterior, or both walls of the vagina. The second and third degree is visible to the naked eye without examination on a gynecological chair. In addition to the loss of the walls of the vagina, protrusion of parts of the organs is observed. There are varieties of the second stage of prolapse:
- Cystocele - prolapse of the anterior vaginal wall with part of the bladder. It is characterized by difficulty urinating, incontinence. Often there is recurrent cystitis.
- Rectocele - prolapse of the posterior wall of the vagina along with part of the rectum. There is a feeling of incomplete bowel movement, a sensation of a foreign body in the vagina, constipation.
In the third stage, complete loss of the walls of the vagina is observed, which is accompanied by the prolapse of the uterus. In this case, seek medical attention immediately.
After examining and establishing an accurate diagnosis, the specialist will explain what to do when the vagina falls out, select the treatment tactics and prescribe the appropriate therapy. In some cases, additional examination may be necessary.
Treatment
There are a number of options available for treating vaginal prolapse. The choice of therapy is based on the following factors: woman's age, severity of symptoms, degree of omission, presence of prolapse of internal organs, desire to have children in the future. Some women may delay going to the doctor because of embarrassment. It is worth remembering that the examination takes a matter of minutes, and delay in treatment can adversely affect the course of the disease.
At the initial stage of vaginal prolapse, treatment is not necessary. To improve the quality of life and prevent the deterioration of the condition, a woman may be recommended to change her lifestyle and exercise the pelvic muscles. Prevention of the development of the disease is to reduce pressure on the pelvic area. Below are some ways:
- weight loss;
- exception lifting heavy objects;
- performing exercises to strengthen the vaginal muscles;
- treatment of constipation;
- normalization of digestion, eating foods fortified with fiber;
- treatment of diseases that cause chronic cough.
Muscle building exercises not only reduce the risk of drooping, but are also used to treat urinary incontinence. Existing organ loss may not be corrected, but will help restore muscle and ligament tone.
In more severe cases, for the treatment of vaginal prolapse can be effective:
- installation of the vaginal pessary;
- hormone replacement therapy;
- laser correction;
- surgical intervention.
Kegel exercises
Kegel exercises are repetitive contractions of the pelvic muscles that control urine flow during urination. The technique is named after the American gynecologist Arnold H. Kegel. He developed a set of exercises to combat urinary incontinence in women after childbirth. The principle of action that underlies training is to strengthen the muscles of the pelvic floor. The success of Kegel exercises depends on the correct technique and regularity of classes.
Studies have shown that women who trained the pelvic muscles have a easier birth, no gaps, the risk of prolapse of the internal organs decreases, and urinary incontinence passes.
Technique of execution:
1 week: retract the muscles and hold them in this position for five seconds, and then relax for five seconds. Repeat four or five times in a row, three times a day.
2 week: increase the number of cuts to 10.
Week 3: increase the number of contractions up to 15 times and the muscle retention time up to 10 seconds.
Week 4: bring the number of repetitions to 20 times.
Kegel exercises can be performed anywhere, anytime and in any position: on the way to work, standing in line at the store, at home in front of the TV.
Some aspects:
- To make sure the muscles used are correct, place your hand on your stomach, buttocks, or thighs. The absence of any movement during training indicates the correctness of the technique.
- Do not cross legs during exercise.
- Do not do exercises with a full bladder or while urinating.
- Do not strain. Exercise should not cause pain. Otherwise, you should check the correctness of their implementation.
Improvements may occur after three to four weeks.
Pessary
Pessary is a special silicone or latex device that has various shapes and sizes. It is used to support the pelvic organs in women: uterus, cervix, vagina, bladder, urethra, rectum, small intestine.
The pessary is made from high quality raw materials of a certain flexibility and density. Its edges are soft and even, therefore trauma to the mucosa is excluded. An allergic reaction is also usually absent.
The introduction of the pessary is usually painless.
There are some contraindications for installing a pessary:
- signs of active infection or inflammation of the pelvic organs;
- allergy to a foreign body, latex or silicone;
- bloody discharge;
Hormone therapy
Hormone replacement therapy is used to maintain the level of estrogen in the blood, which decreases during menopause. An increase in the hormone strengthens the walls of the vagina and the muscles of the pelvic floor. Estrogen enters the body through tablets, creams, injected into the vagina, as well as subcutaneous implants.
Laser correction
Laser rejuvenation is an effective, non-surgical method for eliminating signs of vaginal aging. The laser gently and painlessly acts on the walls of the vagina using a special scanner. As a result, the process of tissue regeneration is started, collagen is produced, which reorganizes and restores the structure of the vaginal mucosa. Tissues become more hydrated, toned and supple.
Using laser correction of the vagina, the following results can be achieved:
- mitigation or elimination of urinary incontinence;
- narrowing of the vaginal canal by increasing the thickness of the walls of the vagina;
- restoration of natural lubrication;
- lightening the color of the vulva, correction of dyschromia, which occurs from aging and friction.
Laser correction of vaginal rejuvenation is a safe procedure. The whole process takes only a few minutes, and most women experience minimal discomfort. After laser exposure, irritation and injury to the vagina should be avoided for 3 to 5 days. To achieve maximum results, 3 procedures are enough.
Contraindications for vaginal laser rejuvenation are the presence of cancerous tumors, active manifestations of skin diseases such as psoriasis, lichen planus in the vagina at the time of treatment.
Surgical intervention
In severe cases of vaginal prolapse, surgical restoration and reconstruction methods are used. Usually, this type of therapy is resorted to in the absence of the results of non-invasive treatment. The choice of type of operation for vaginal prolapse is based on the severity of the woman's condition. The procedure is performed under general anesthesia.
The types of surgical intervention include:
- colpoplasty - surgery for prolapse of the vaginal wall;
- hysterectomy - removal of the uterus;
- fixation of the vagina and pelvic organs with a non-absorbable synthetic mesh,
- vaginal and perineal biorevitalization - tissue rejuvenation by the introduction of hyaluronic acid.
Possible complications
All surgical procedures may entail some risks and complications. The following symptoms are distinguished:
- damage to neighboring organs such as the bladder;
- infection, in order to reduce the risk of its occurrence before and after surgery, antibiotics are prescribed;
- pain during sex;
- vaginal discharge;
- vaginal bleeding;
- thrombosis in veins;
- relapse of prolapse and prolapse of organs.
Body recovery
Most vaginal reconstruction operations take about an hour. Depending on the type of surgery, hospital stay takes up to 5 days. Sutures usually resolve on their own within a few weeks.
In the postoperative period, a woman may experience vaginal bleeding similar to menstruation. Usually it lasts no more than 4 weeks. At this time, using tampons is prohibited. You can take a bath after the discharge stops.
Full recovery of the body can take up to 3 months. During the rehabilitation period, it is recommended to observe the following rules:
- avoid lifting weights (nothing more than 2 kg);
- avoid any physical exertion; short walks and exercises for the prevention of thrombosis prescribed by a doctor in the hospital are allowed;
- prevent constipation, drink plenty of fluids, foods high in fiber, and use laxatives if necessary.
Sexual life can be resumed 6 weeks after surgery.
If the amount of discharge increases or an unpleasant odor appears, you should consult your doctor to prevent infection. In addition, a woman should visit a gynecologist if the following symptoms appear:
- temperature increase above 38 degrees;
- severe abdominal pain;
- cramping and burning when urinating.
Prevention
The prolapse and prolapse of the walls of the vagina, pelvic organs are usually found in elderly women, after a difficult birth or physical labor. To reduce the risk of prolapse, improve the condition or to avoid exacerbation, it is recommended to follow some prevention methods:
- do regular exercises to strengthen the muscles of the pelvis;
- maintain optimal weight;
- avoid obesity;
- eat balanced;
- eat large amounts of vegetables, fruits, whole grain bread;
- prevent constipation;
- Do not sit for a long time on the toilet;
- Do not push too hard during bowel movements;
- avoid lifting weights;
- lead a healthy lifestyle, stop smoking.