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Uterovaginal Prolapse

Pelvic organ prolapse is a condition that only affects women, and when it does, many women suffer in silence, being too shy to seek treatment. Pelvic organ prolapse happens when the tissues that support the organs in the lower belly relax. When these tissues, sometimes called the "pelvic floor" relax too much, the organs drop down and press against or bulge into the vagina.

If the bladder bulges into the vagina, doctors call this problem "cystocele." If the rectum bulges into the vagina, it’s termed "rectocele." Uterine prolapse means the uterus has bulged into the vagina.

This bulge at the vulva causes anxiety, fear and worry that it may a symptom of cancer. Women with this condition may feel a dragging or heaviness in their pelvic area, but when seeking treatment, they may be told that there is nothing wrong with them. 

Many women with this problem show no symptoms. But some with pelvic organ prolapse display symptoms that include:

  • Fullness or pressure in the pelvis or vagina
  • A bulge in the vagina or coming out of the vagina
  • Leaking urine when they laugh, cough, or sneeze
  • A need to urinate all of a sudden

When they use the toilet, some women need to press on the bulge in the vagina with a finger to completely pass out all their urine or to finish a bowel movement.

How is pelvic organ prolapse treated?

Women who display no symptoms or who are not bothered by their symptoms do not need treatment. For women with symptoms that bother them, doctors suggest different treatments, including:

  • Pelvic floor muscle exercises
  • A vaginal pessary. This device fits inside the vagina to support the bladder and push it back into place. Pessaries come in different shapes and sizes.
  • Surgery. A surgeon can move dropped organs back where they belong and strengthen the tissues that keep them in place. Women should have this type of surgery only if they are done having children.

Can pelvic organ prolapse be prevented?

You can reduce your chances of pelvic organ prolapse if you:

  • Lose weight if you are overweight
  • Get treated for constipation if you suffer from the condition
  • Avoid activities that require heavy lifting

Can I do anything on my own to feel better?

Some women feel better if they do pelvic muscle exercises, which strengthen the muscles that control the flow of urine and bowel movements. These exercises are also known as "Kegel" exercises.

To learn Kegel exercises, you first need to ask your doctor or nurse on how to do them right. This is because you will need to identify the right muscles to tighten.

A woman can learn to do Kegel exercises by:

  • Putting a finger inside her vagina and squeezing the muscles around her finger; or
  • Pretending that she is sitting on a marble and has to pick it up using her vagina

Women can also learn to do these exercises by stopping and starting the flow of urine. If you do this, make sure to do this only once or twice to figure out the correct muscles. Doing this continuously could cause a bladder infection.

No matter how you learn to do Kegel exercises, the important thing to know is that the muscles involved are not in your belly or your thighs. After you learn which muscles to tighten, you can perform these exercises in any position e.g. sitting in a chair or lying down. You do not need to do them while in the bathroom.

Do the exercises three times a day, on three or four days a week. Each time, flex your muscles 10 times, and hold them tight for five seconds each time you tighten. Keep up this routine for at least three months. You will probably notice results, but it might take a little time. Good luck!

Article by:
Consultant Obstetrician & Gynaecologist
Dr Cecilia Wong
MD(USM), Masters in O&G(Mal), AM Fellowship in Urogynaecology(Adelaide, AUS)