Vaginal prolapse, also known as pelvic organ prolapse, occurs when one or more of the organs in the pelvis slip down from their normal position, pushing the vaginal wall down, causing a bulge into the vagina or out past the labia. Occasionally the walls themselves droop but usually it’s the womb (uterus), bowel, bladder or top of the vagina that have descended, pulling the wall with them.
Symptoms vary but include a feeling of heaviness in the lower abdomen or genital area, dragging internal discomfort, a feeling of swelling or something coming down inside the vagina, difficulty peeing, discomfort during sex, seeing a bulge coming out. Sometimes there are no symptoms but it’s noticed during examination, such as for a cervical smear.
Your doctor will examine you, including doing an internal, during which they’ll feel for lumps in the pelvic area and inside the vagina. They will gently put an instrument called a speculum into the vagina, holding the walls open so they can see if there’s a prolapse, possibly asking you to lie on your left-hand side and examine you in that position to get a better assessment. You may be asked for a urine sample to check for infection.
Treatment
If you don’t have any symptoms, or the prolapse is mild and not bothering you, you may not need any medical treatment, simply being reviewed if things change. You’ll be advised about pelvic floor exercises, weight management, avoiding heavy lifting and preventing constipation, as anything that increases the pressure within the abdomen can make the prolapse worse.
Other treatments depend on the type, cause and severity of the prolapse, your symptoms and your overall health.
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