What Is a Vaginal Wall Prolapse?

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  • Written By: Jessica Hobby
  • Edited By: Heather Bailey
  • Last Modified Date: 15 January 2020
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A vaginal wall prolapse, more commonly referred to in the medical community as a pelvic organ prolapse, occurs when muscles and ligaments surrounding the walls of the vagina, called fascia, become weak. When the fascia becomes weakened because of age, childbirth or a hysterectomy, part of or the entire vaginal wall begins to fall, or prolapse, and causes other pelvic organs surrounding the wall to also prolapse. There are four types of pelvic organ prolapse, which occur based on which part of fascia has been weakened.

The first type of a vaginal wall prolapse, a rectocele, occurs when the back part of the vaginal wall that sits against the rectum prolapses. Specifically, a rectocele happens when the tissue between the rectum and the vagina weakens. It typically causes a bulge and becomes most noticeable when a woman strains during a bowel movement.

A cystocele is another type of prolapse that occurs when the front wall of the vagina prolapses. When the front wall prolapses, it also causes the bladder to prolapse. Women who have a cystocele are typically burdened with urinary stress incontinence, which is urine leakage that typically happens while coughing, sneezing, walking and running.

The next type of vaginal wall prolapse is a uterine descensus, which is a prolapse of the uterus that occurs when the top of the vagina weakens. A uternine descensus is characterized by different stages. Early stages are mild, while final stages also include a weakening of the front and back vaginal walls. Eventually the entire vagina prolapses, which causes the uterus to protrude from the vagina.

The final type of vaginal wall prolapse is an enterocele, also called a vaginal vault prolapse combined with a herniated small bowel. The top of the vagina prolapses toward the vaginal opening because of a hernia in the small bowel. The weakening of the fascia causes the front and back vaginal walls to separate, which allows the bowels to push against the skin of the vagina. An enterocele is the most common type of vaginal wall prolapse to occur after a hysterectomy. It also results in loss of bladder control.

In addition to incontinence and protruding skin from the vagina, vaginal wall prolapses produce some other annoying, but not life threatening symptoms. Women may experience pain during intercourse, regularly contract urinary tract infections, constipation and difficulty urinating. There are a variety of medical and home treatments for a vaginal prolapse, including kegel exercises, surgery and hormone replacement therapy.

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Post 5

I had a complete hysterectomy 28 years ago and was on hormones until five years ago. I had read several times that hormones cause cancer so I stopped using them. It was the worst mistake of my life. I have a prolapsed vagina and bladder. The prolapsed vaginal walls put pressure on the bladder, which causes frequent incontinence. I have been to a urologist and to two OB/GYN doctors. I was told by the doctors that using the hormone replacement therapy would improve my vaginal walls, however it would never ever return to being as they were prior to eliminating usage. I have used Imvexxy and Intrarosa.

Post 4

@ladyjane - Many women your mother's age experience bladder prolapse symptoms whether they've had surgery or not. Unfortunately it's caused from aging, childbirth and even menopause which weakens the vaginal muscles.

It is very likely that your mother will have to undergo colpocleisis surgery again to lift the anterior vaginal wall some more.

This type of surgery almost always involves the risk of recurrence due to the fact that the muscles and nerves continue to weaken as we age.

Unfortunately the second surgery might not have as good of results as the first one because the tissues are worn thin and oftentimes a special graft must be used to support the vaginal wall.

If she has gone

through menopause and there's no chance she will ever have children again then another option for her to consider is a hysterectomy to remove the uterus.

The best advise of course will come from her physician. Together they should discuss her options to better know what is the right choice for her. I hope this helps answer your questions. Good luck to the both of you.

Post 3

My mother had surgery for a prolapsed bladder about two years ago and now she's showing signs that her bladder is dropping again. Is this possible?

Her first surgery went very well but she's almost seventy years old now and I'm just so worried about her health. Will she have to go through this surgery again? Are there any other options for her?

Post 2

@whitesand - The replacement of estrogen is beneficial by helping to strengthen the vaginal muscles and to maintain muscle tone and stability.

Hormone replacement therapy is especially important for women after menopause because the body stops producing estrogen naturally causing the vaginal muscles to weaken, which could eventually lead to a complete pelvic floor prolapse.

Post 1

I understand the importance of Kegal exercises and how they help maintain the strength of the vaginal wall and of course why surgery may be a necessary treatment.

But what benefits does hormone replacement therapy have in the treatment of a prolapsed vagina?

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