Vaginal Prolapse

Vaginal prolapse is also referred to as “Pelvic Organ Prolapse” or “Urogenital Prolapse”.  It is due to a weakness of the pelvic floor, which allows the organs surrounding the vagina to bulge or herniate into the vagina.

Types of Vaginal Prolapse

There are several types of vaginal prolapse, which often occur in combination, because there is often a weakness of the pelvic floor in multiple areas.  Vaginal Prolapse is named after the tissue or organ that protrudes into the vagina.

In front of the vagina lies the bladder and urethra.  When the urethra prolapses into the vagina, this is called a “urethrocoele”. When the bladder bulges into the vagina, this is called a “cystocoele”.  A combination of bladder and urethral prolapse is referred to as a “cystourethrocoele”.

Behind the vagina lies the rectum.  When the rectum prolapses into the back of the vagina, this is called a “rectocoele”.  A prolapse of the small bowel into the vagina is called an “enterocoele”.

“Uterine prolapse” refers to the protrusion of the uterus (womb) into the vagina.  In women who have had a hysterectomy, the top of the vagina can protrude into the vagina, and this is referred to as a “vault prolapse”.

How common is Vaginal Prolapse?

Vaginal Prolapse is more common as women get older, but it can also affect younger women.  Almost half of all women who have delivered a child will have some form of vaginal prolapse some time later in life, however many of them do not seek treatment.  Overall only about 10-20% of women with prolapse will seek treatment by a gynaecologist.  This may be because some of these women are not bothered by the prolapse, whilst others may be too embarrassed to seek help.

Symptoms of Vaginal Prolapse

Vaginal Prolapse can cause many embarrassing symptoms for women, and can significantly affect the lives of many women.  The symptoms may include:

• Bulge, or a sensation of heaviness or dragging
• Backache
• Vaginal irritation or dryness
• Difficulty or pain with intercourse
• Inability to empty bladder completely
• Frequent urination
• Incomplete bowel emptying
• Inability to open the bowels (some women may need to push the prolapse back with their fingers before they can open their bowels)

Women with vaginal prolapse may also have concurrent problems with urinary incontinence.

Treatment Options for Vaginal Prolapse

Conservative Treatment for Vaginal Prolapse

• Vaginal Pessary
  • There are many types and sizes of pessaries available.  Dr Law will recommend the appropriate pessary for you depending on the nature of your prolapse and anatomy.
  • The pessary sits in the vagina and pushes the prolapsed organs away from the vagina.  The pessary can be left in place during intercourse.
  • Dr Law will see you every 3-4 months to change your pessary, and to ensure that the pessary is not causing any problems such as erosions of the vaginal wall.
• Pelvic Floor Physiotherapy
• Topical Oestrogen

Surgical Treatment for Vaginal Prolapse

• Surgery aims to correct the anatomical defect in the pelvic floor, as well as to repair the prolapse.  This reduces the chance of recurrence following surgery.
• The aim of surgery is to alleviate symptoms and to restore bowel, bladder and/or sexual function.

Dr Ken Law is a Brisbane Gynaecologist with special interest in the management of Vaginal Prolapse and Urinary Incontinence.  For further information and to discuss your specific conditions and treatment, please contact Dr Ken Law to arrange an appointment at Greenslopes Obstetrics and Gynaecology.