Vaginal Prolapse…what is this all about?

Some ladies find themselves in a quite a situation when they experience vaginal prolapse.  You may have heard of bladder prolapse but didn’t really know what it is.  The symptoms of bladder prolapse can range from not even being aware of the prolapse to more bothersome symptoms of difficulty urinating or having bowel movements or feeling the prolapse protrude through the vagina.

Normally, the bladder is held in place by supportive pelvic floor muscles and tissue. When these tissues become weak, the bladder can bulge through this layer into the vagina, like a hernia.  This is called a cystocele.  If the area of herniation is on the posterior side of the vagina, and the rectum bulges through, this is a rectocele.

Treatment options for prolapse lead us down three different pathways.  Either the prolapse is not bothersome and there is no difficulty emptying the bladder and no increase in urinary tract infections, so we can continue to monitor it ...and it may not get any worse.  Now, if there are bothersome symptoms, we have two options.  Either we go with a more conservative option of a pessary or we consider a surgery to correct the prolapse.

A little more about pessaries...a pessary is a silicone vaginal prosthesis that is an effective medical device to relieve a prolapse and can help with urinary incontinence. Similar to a diaphragm, this device can be taken in and out by the woman to clean and care for herself or if she desires it may removed and cleaned at the office at regular intervals.  You are fitted for the pessary in the office as there are a number of different styles of pessaries that work for prolapse and incontinence.  Pessaries have been around thousands of years.  In ancient times, pomegranates were used to do the job and our options have just continued to broaden since the 1800s with the invention of the ring pessary.  As materials have developed, so have pessaries and now we have a silicone pessary available in a variety of shapes and sizes.

However, sometimes there is just not enough pelvic support left to facilitate a pessary working well for the woman.  Then we consider the benefits and risks of surgical correction of the prolapse.  I hope you learned more about vaginal prolapse. If you have any questions or desire to further discuss your urological concerns, please call our office at (330) 685-9920.  Thank you!

This article was written by Anna Myers, a women’s health, urology and family board certified nurse practitioner working in our office here in Wooster, Ohio.