About one in four women will experience symptoms of vaginal prolapse in their lifetime – and it doesn’t only impact women who have gone through childbirth. “It’s not all about babies. There are also genetic factors,” Catrina Crisp MD, a urogynecologist at Cincinnati Urogynecology Associates, explains.
Vaginal Prolapse: What is it?
Vaginal prolapse occurs when the structure of the vagina isn’t as well-supported as it used to be. The vagina stretches or expands to protrude on other organs.
Symptoms may include:
- Not being able to empty your bladder completely
- Your bladder feeling full all the time
- Feeling pressure in your vagina
- Feeling or seeing a bulging at the opening of the vagina
- Having pain when you have sex
- Leaking urine when you cough, sneeze, or lift something
- Getting bladder infections
“Most patients describe a pressure or bulge – especially at the end of the day, when they’ve been up working, gardening or carrying a lot of things that are heavy,” Dr. Crisp explains. “The more things they’re lifting, the more they’re up on their feet, and the more they’re doing, the more symptomatic they’re going to be.”
Vaginal Prolapse: Who’s at Risk?
If your mom or older sister experienced vaginal prolapse, you’re automatically at risk for developing this condition. In these cases, if you have a true connective tissue disorder (that wasn't brought on by pregnancy or childbirth), the onset of vaginal prolapse is more likely to occur at an earlier age, like your late 20s or early 30s.
On the other hand, pregnancy ups your risk for having vaginal prolapse as well, especially if you:
- Have given birth to multiples
- Had a long labor
- Had a more difficult delivery
“Those all increase your risk, but simply being pregnant increases your risk, regardless of how you deliver – meaning Cesarean-section or vaginal delivery,” Dr. Crisp adds.
Can I Treat Vaginal Prolapse Without Surgery?
Your doctor will likely recommend that you start with pelvic floor physical therapy to help strengthen those weak vaginal muscles, especially if you have mild symptoms. Physical therapy typically involves one or two weekly sessions for a few weeks. Physical therapy also involves patient education, so you can then perform the exercises from the convenience of your own home. Sometimes physical therapy is done in conjunction with surgery.
Dr. Crisp also suggests making lifestyle changes to offset symptoms; for example, if you already have a small amount of prolapse, avoid heaving lifting or straining those muscles.
Another non-surgical approach is a vaginal pessary, which is a rubber or plastic donut-shaped device, inserted in the vagina, to hold the uterus in place.
Surgically Treating Vaginal Prolapse: How Does it Work?
“Obviously, most patients want the most minimally invasive option – whatever can get them feeling better and back to living the fastest,” Dr. Crisp explains. At TriHealth, most surgeries are done through the vagina or robotically, which means:
- Less pain
- Shorter hospital stay (usually, one night)
- No large incision on the abdominal area
“The biggest thing is to know there is somebody out there who specializes in exactly what your problem is,” Dr. Crisp stresses. “The decision to seek treatment is the best one you can make.”