DEERFIELD BEACH, FLORIDA Many women can suffer from symptoms of vaginal prolapse and stress urinary incontinence. Difficulty controlling urine and changes in bowel habits are usually the two most common symptoms. Vaginal prolapse is an issue in which structures such as the uterus, bladder, urethra, small bowel, or the vagina itself begin to fall out of their normal positions, says Dr. Mark Scheinberg, a cosmetic vagina surgery expert. Without treatment, the structures can prolapse farther. Scheinberg, a cosmetic gynecology specialist, explains the different types of vaginal prolapse.
Rectocele, Or Rectum Prolapse
This type of prolapse involves the back wall of the vagina. When it weakens, the rectal wall could push against the vaginal wall. This can result in a bulge and could become noticeable during bowel movements. This could occur as a result of injuries sustained during childbirth.
Cystocele, Or Bladder Prolapse
When the front vaginal wall prolapses, the bladder could fall into the vagina. The urethra can prolapse as well, which is known as an urethrocele. If the urethra and bladder fall, the condition is called cystourethrocele. A common symptom of this combination may be urinary stress incontinence, a urine leakage that can occur while coughing, sneezing or exercise.
This can happen when a group of ligaments, called uterosacral, at the top of the vagina weaken. Once theses ligaments weaken, the uterus can fall. A vaginal vault prolapse can occur after a hysterectomy, which is the removal of the uterus. The uterus gives support for the top of the vagina, says Scheinberg, a cosmetic vagina surgeon. This condition typically happens after a hysterectomy.
Around 30 to 40 percent of women can develop some type of vaginal prolapse in their lifetime. Typically, prolapse occurs after menopause, childbirth or a hysterectomy, according to the EMedicine Health website. During childbirth, as the baby moves through the birth canal, the supporting tissues surrounding the vagina separate and weaken, says Scheinberg, a hymenoplasty provider. The weakening can gradually get worse and later could cause the pelvic structures to drop from their original position.
For those who are going through menopause, estrogen can help to keep muscles and tissue strong. Once the estrogen level lowers, the support structures may weaken. To patients, who have had a hysterectomy, the uterus is important to the support structure at the top of the vagina. Without the uterus, the top of the vagina can fall.
A number of other risk factors include advanced age, obesity, unusual strain placed on supporting structures and unusual increases in abdominal pressure. Most cosmetic gynecologists would agree that the most reliable way to make a diagnosis is through a physical examination and gathering of patient history, Scheinberg says. Each section of the vagina can be checked to determine the type and extent of prolapse, and to see which treatment is appropriate.
Depending on the circumstances, tests may include a Q tip test, a bladder function test and pelvic examination, says Scheinberg. Definitive treatment is to surgically correct the specific defects.
About Dr. Mark Scheinberg
Board Certified in Obstetrics and Gynecology in the state of Florida since 1981, Dr. Scheinberg offers the latest in minimally invasive vaginal surgery. He has performed over 10,000 surgical procedures. Scheinberg has trained under the world renowned Professor Dr. Adam Ostrzenski, Ph.D. He is an internationally known speaker and lecturer about cosmetic gynecology. He is a member of the International Society of Cosmetic Gynecologists and a Diplomat for the American Board of Obstetricians and Gynecologists.
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