The uterus and bladder are kept in their normal locations just above the inside end of the vagina by a "hammock" of supportive muscles and ligaments. Due to wear and tear on these pelvic supporting structures, the bladder floor and the bottom of the uterus bladder floor, sag through the muscle and ligament layers.
When this occurs, the uterus or bladder may protrude into the vaginal opening. In extreme situations, the sagging uterus or bladder might descend far enough that the bulge appears at or protrudes from the vaginal opening.
Uterine prolapse occurs when the uterus sags downward. When the bladder sags, this is referred to as bladder prolapse, which is also referred to as a cystocele.
Various stressors can lead to prolapse of the pelvic muscles and ligaments, resulting in uterine or bladder prolapse. The strongest stress on these muscles and ligaments occurs during delivery. Prolapse is more likely to occur in women who have had several pregnancies and vaginal delivery.
Constipation with a habit of regular straining to evacuate faeces and a chronic cough might contribute to prolapse. Additionally, obesity can put pressure on the pelvic muscles.
Support difficulties in the pelvis exacerbate during menopause, as the pelvic tissues rely on estrogen to maintain their tone, and estrogen levels decline the following menopause.
According to some physicians, almost half of all women may experience some degree of uterine or bladder prolapse in the years following childbirth. These conditions go undiagnosed and untreated in the majority of women. Only 10% to 20% of women with pelvic prolapse seek medical attention for their symptoms.
Symptoms
Mild cases of bladder or uterine prolapse are typically asymptomatic. A more advanced prolapse may present with any of the following symptoms:
Vaginal, pelvic, lower abdominal, groin, or lower back discomfort.
The discomfort is frequently characterized as a pulling or aching sensation.
It might be exacerbated during sexual intercourse or menstruation.
It might be exacerbated during sexual intercourse or menstruation.
Vaginal heaviness or pressure.
Some women get the sensation that something is going to fall out of the vagina.
A vaginal bulge of moist pink tissue. This exposed tissue may become inflamed, resulting in itching causing sores and blisters. This exposed tissue may become inflamed, resulting in itching causing sores and blisters.
Urine leakage, which is worsened by hard lifting, coughing, laughing, or sneezing.
Frequent urinary tract infections, which are due to the bladder not getting emptied completely when you urinate.
An urge to insert your fingers into your vagina, rectum, or surrounding skin in order to empty your bladder or have a bowel movement.
Difficult bowel movement.
Pain during sexual intercourse, urine leaking during sex, or an inability to achieve an orgasm.
Moist discharge that stains your underwear.
Diagnosis
An experienced physician can typically detect uterine or bladder prolapse during a pelvic examination. MRI (magnetic resonance imaging) testing may be necessary to confirm the diagnosis in some cases.
In some cases, particularly if you are prone to urinary infections or have trouble holding your urine, your doctor may request one or more tests to assess your bladder function.
Urodynamic studies evaluate the function of your bladder and can determine if it empties completely. The pressure inside your bladder is determined by passing fluid into it via a small tube. After the dye is injected into your urethra to fill your bladder, an X-ray video taken can be used to determine whether its form is distorted. This procedure is referred to as a voiding cystourethrogram.
Occasionally, you may correct a minor incidence of prolapse by strengthening the pelvic muscles. In other situations, as the woman ages, the degree and severity of the prolapse may worsen. This process can be more rapid in some women.
Exercise or hormone treatments are typically ineffective in advanced or severe cases of prolapse. Often, surgery improves or eliminates pelvic organ prolapse.
Prevention
Occasionally, you may correct a minor incidence of prolapse by strengthening the pelvic muscles. In other situations, as the woman ages, the degree and severity of the prolapse may worsen. This process can be quicker in some women than in others.
Exercise or hormone treatment are typically ineffective in advanced or severe instances of prolapse. Often, surgery improves or eliminates pelvic organ prolapse.
Treatment
In moderate cases, strengthening the pelvic floor muscles may be enough to alleviate symptoms of prolapse. Kegel exercises are a wonderful method to increase your pelvic support.
Kegel exercises are done by Squeezing the muscles that you would use to keep yourself from passing pee or gas. Contraction should be held for a few seconds and then released. After the contraction, completely relax your pelvic floor muscles. Rep ten times more. Aim to do four to five sets every day.
Most women find an improvement in bladder control and may experience less discomfort or fewer symptoms over time.
A physician can insert a pessary, a rubbery ring-shaped device, into the top part of your vagina. Pessaries can help to keep the uterus and bladder in place and preventing them from sagging into the vagina. They are detachable and may be cleaned on a regular basis.
A prolapsed bladder or uterus may require surgery, which can be performed through the vaginal, through an abdominal incision, or by laparoscopy. The method selected is determined by a woman's age, the severity of her symptoms, her medical history, her desire for future fertility, and her desire to have sex. The objectives are to restore normal anatomy, alleviate symptoms, reestablish normal bowel and bladder function, and reestablish sexual function. In some situations, surgical hysterectomy (removal of the uterus) is recommended.
When should you visit a Doctor?
Prolapse of the pelvic organs is a very benign condition meaning it is nonthreatening. If you are experiencing troublesome symptoms and believe you may have this condition, you should consult your physician. Additionally, it is important to notify your doctor of any changes in urinary symptoms, as urine infections are a possible complication of prolapse.
Prognosis
Minor prolapse of the uterus or bladder can be corrected with pelvic floor muscle strengthening exercises. Once prolapse reaches a more advanced level, it will continue to deteriorate in the absence of surgical intervention or pessary support.
Mild to severe prolapse is unlikely to have serious medical implications and may not require treatment. Advanced, severe, or complete prolapse typically requires pessary support or surgical therapy to reduce urine incontinence, urinary retention, vaginal ulceration, sexual dysfunction, or difficulty passing stool.
