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Vaginal Prolapse

Vaginal prolapse is a weakening or breaking of the network of ligaments, muscles and skin in and around the vagina that support and hold the pelvic organs and tissues in place.

What is vaginal prolapse?

Vaginal prolapse is a weakening or breaking of the network of ligaments, muscles, and skin in and around the vagina that support and hold the pelvic organs and tissues in place. If a woman’s uterus, urethra, bladder, rectum, small bowel, or vagina falls out of its normal position, she is suffering from vaginal prolapse. If untreated, these organs or structures will continue to prolapse into the vagina or through the vaginal opening.

There are five types of vaginal prolapse:

  1. Cystocele (bladder) – if the front wall of the vagina prolapses, the bladder can prolapse into the vagina.
  2. Enterocele (small bowel) – this occurs when the front and back walls of the vagina separate, allowing the intestines to push against the vaginal skin.
  3. Rectocele (rectum) – a prolapse of the back wall of the vagina. When this wall weakens, the rectal wall will push against it. This creates a bulge which may be noticeable during bowel movements.
  4. Prolapsed uterus  – a weakening of the uterosacral ligaments at the top of the vagina. This causes the uterus to fall and the vaginal walls to weaken.
  5. Vaginal vault prolapse – following a hysterectomy, the top of the vagina may gradually fall toward the vaginal opening. The walls of the vagina will then weaken, and the top of the vagina could protrude out of the body through the vaginal opening. As a result, the vagina is turned inside out.

What are the causes?

The most common causes of vaginal prolapse include:

  • Giving birth – if your labor is particularly long or complicated, or if your child is large, the muscles, ligaments, and tissues in & around the vagina could be damaged. Childbirth is commonly associated with cystocele.
  • Hysterectomy – the uterus is removed during a hysterectomy, and without it, the top of the vagina may gradually fall toward the vaginal opening. This condition is called vaginal vault prolapse. Enterocele is also commonly associated with hysterectomies.
  • Menopause – following menopause, the body’s estrogen levels decline. Estrogen is a hormone that helps to strengthen the tissues and muscles of the pelvic support structures.

Old age, obesity, previous pelvic surgery, strenuous physical activity, and dysfunction or abnormalities with the nerves and tissues are all additional risk factors for this condition.

What are the symptoms?

Symptoms will depend on the type of prolapse that you have, but most women describe a dragging sensation or a feeling of pressure in the area of that dragging. There may even be a visible protrusion. If your prolapse is more advanced, the symptoms will be more severe. Additional symptoms may include:

  • Urinary stress incontinence (cystocele in combination with another type)
  • Pressure in the pelvis or vagina
  • Frequent urinary tract infections (UTIs)
  • A decrease in pressure or pain when you lie down
  • Painful sex
  • A mass at the opening of the vagina
  • Difficulty emptying the bladder (cystocele)
  • Difficulty emptying the bowel (enterocele, rectocele or vaginal vault prolapse)
  • Constipation (rectocele)
  • An enlarged vaginal opening (vaginal vault prolapse)
  • Increases in pain while standing for long periods (prolapsed uterus, enterocele, or vaginal vault prolapse)

How is vaginal prolapse diagnosed & treated?

If you are experiencing any of the symptoms listed above, schedule an appointment at Central Texas Urogynecology & Continence Center. Dr. Antonini and staff will provide you with the correct diagnosis and the proper treatment plan. Some of the more common tests include an ultrasound, an MRI, a bladder function test, a Q-tip test, and a pelvic exam.

To repair a prolapse, Dr. Antonini uses the da Vinci robot-assisted system to perform advanced surgery. At Central Texas Urogynecology & Continence Center, we have the technology and expertise required for you to feel like yourself again.

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