Vaginal prolapse occurs when the pelvic muscles and connective tissues weaken, allowing other organs (including the uterus, bladder, or parts of the lower intestine) to drop beyond their normal position and into the vaginal canal. Characterized by feelings of fullness, pressure, or pain in the vagina, the condition affects up to 50% of women at some point in their lives.
In addition to vaginal discomfort, prolapse can cause several frustrating symptoms that disrupt daily life, including painful intercourse, urinary or fecal incontinence, and constipation. Vaginal childbirth and menopause are common causes of the condition, but other risk factors include extreme physical activity and genetics.
Just because vaginal prolapse is common doesn’t mean you have to live with it. Fortunately, there are ways to repair a prolapse through the following treatments.
Prior to pursuing surgical treatments, you may be advised to try a pessary. This device resembles a diaphragm, and is placed in the vagina to lift the bladder or provide compression to the urethra to stop the leakage of urine. While the treatment is a low-risk, nonsurgical option, it does require ongoing care, including routine removal and cleaning. Moreover, the treatment may not be ideal for patients with very weak pelvic floor muscles.
Also known as colpocleisis, obliterative surgery involves stitching the vagina shut. This approach has yielded positive outcomes for women aged 70 or older, but it does prevent vaginal intercourse. For this reason, obliterative surgeries are often reserved for women who cannot withstand more extensive procedures.
For patients wishing to have penetrative vaginal intercourse, reconstructive surgery aims to reconstruct the vaginal canal. The American College of Obstetricians and Gynecologists outlines the following types of reconstructive procedures to address vaginal prolapse:
- Native Tissue Repair: In this treatment, the patient’s own tissues are used to correct the prolapse. A surgeon will attach the prolapsed area to a pelvic ligament or muscle for support.
- Colporrhaphy: Performed through the vagina, a colporrhaphy resolves a prolapse of either the front or back wall of the vagina. Stitches are placed to provide support to the surrounding organs, including the bladder and rectum.
- Sacrocolpopexy: This approach lifts the vagina into its original position through the insertion of a synthetic mesh, which attaches to the vaginal walls and tail bone. The procedure may be performed through an abdominal incision or laparoscopically.
- Sacrohysteropexy: This procedure is ideal for patients experiencing vaginal and uterine prolapse who wish to avoid a hysterectomy. It involves the placement of a surgical mesh that runs from the cervix to the sacrum to reposition the uterus.
- Vaginal Mesh: If the patient’s pelvic tissues aren’t strong enough to support the prolapse on their own, they may be recommended for vaginally placed mesh. While the treatment may repair any type of prolapse, it presents higher risks and is therefore reserved for only select patient populations.
As with any procedure, the decision to pursue surgical treatment for prolapse is best made after an in-depth discussion that examines symptoms, risks, and benefits with your doctor. Our providers are ready to discuss both surgical and non-surgical options to address vaginal prolapse and restore your quality of life. Schedule an appointment by calling (404) 352-2850 or booking one online.