Definition
Vaginal prolapse is the inward and downward bulging of the vaginal walls. The severity of vaginal prolapse may be defined as:
- First degree—collapse into the upper part of the vagina
- Second degree—collapse further into the vaginal canal, down to the level of the vaginal opening
- Third degree—collapse that extends beyond the opening
Causes
Vaginal prolapse is caused by weakened support structures in the pelvic region. The lack of support causes the walls of the vagina to weaken, sag, and collapse.
Risk Factors
Increasing age increases your risk of vaginal prolapse. Other factors include:
- Multiple vaginal deliveries
- Post-menopause
- Obesity
- Straining caused by chronic cough, constipation, or heavy lifting
- Family history
Symptoms
Symptoms may include:
- Pelvic pressure
- A feeling of vaginal fullness or heaviness
- A feeling of pulling in the pelvis
- Vaginal discomfort
- Urinary urgency and frequency
- Urination when laughing, sneezing, coughing, or exercising
- Constipation
- Difficult or painful intercourse
- Low backache that is relieved with lying down
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will also be done. Vaginal prolapse that has no symptoms may be diagnosed during routine examinations. Your doctor may refer you to a gynecologist, who will do a pelvic exam.
Treatment
Talk with your doctor about the best treatment plan for you. First or second degree prolapse without symptoms may not require treatment. Treatment options include:
Kegel Exercises
Kegel exercises involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles.
Medications
Your doctor may recommend estrogen therapy. This may help prevent further weakness of the pelvic floor.
Pessary Insertion
Your doctor may insert a pessary into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.
Surgery
Vaginal prolapse that is severe or associated with lasting symptoms may require surgery. Surgery may involve repairing the pelvic floor structure or, in some cases, to suture the vagina.
If you are diagnosed with vaginal prolapse, follow your doctor's instructions.
Prevention
To help prevent vaginal prolapse:
- Do Kegel exercises.
- Maintain a healthy weight.
- To avoid constipation, eat plenty of fruits, vegetables, and whole grains. Drink plenty of fluids throughout the day.
- If you smoke, quit. Smoking may cause chronic coughing and weakening of connective tissues.
- Limit heavy lifting.
Revision Information
- Reviewer: Andrea Chisholm; Brian Randall, MD
- Review Date: 04/2013 -
- Update Date: 04/22/2013 -