Vaginal fullness may be caused by pelvic organ prolapse. Pelvic organ prolapse is a condition in which organs may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these organs may prolapse farther into the vagina or even through the vaginal opening if their supports weaken enough.
Organs affected by pelvic organ prolapse include:
- The Uterus
- Rectum
- Bladder or Urethra
- Small bowel
- The vagina itself
Types of Pelvic Organ Prolapse:
- Rectocele (prolapse of the rectum) — This involves a falling of the back wall of the vagina When this wall weakens; the rectal wall pushes against the vaginal wall, creating a bulge. This bulge may become especially noticeable during bowel movements.
- Cystocele (prolapse of the bladder, bladder drop) — This can occur when the front wall of the vagina falls. As a result, the bladder may fall into the vagina. When this condition occurs, the urethra usually falls as well. When both the bladder and urethra fall, this condition is known as a cystourethrocele. Urinary stress incontinence (urine leakage during coughing, sneezing, or exercise) is a common symptom of this condition.
- Enterocele (herniated small bowel) — The weakening of the upper vaginal supports can cause this type of prolapse. This condition primarily occurs following a hysterectomy, and results when the front and back walls of the vagina separate, allowing the intestines to push against the vaginal skin. This condition often causes a Vaginal vault prolapse.
- Prolapsed uterus (womb) — This involves a weakening of a group of ligaments called the uterosacral ligaments at the top of the vagina. This causes the uterus to fall, which commonly causes both the front and back walls of the vagina to weaken as well.There are four stages of uterine prolapse:
- First-degree prolapse: The uterus droops into the upper portion of the vagina.
- Second-degree prolapse: The uterus falls into the lower part of the vagina.
- Third-degree prolapse: The cervix sags to the vaginal opening and may protrude outside the body. This condition is also called procidentia, or complete prolapse.
- Fourth-degree prolapse: The entire uterus protrudes entirely outside the vagina. This condition is also called procidentia, or complete prolapse.
- Vaginal vault prolapse — This type of prolapse may occur following a hysterectomy. Because the uterus provides support for the top of the vagina, this condition is common after a hysterectomy, with upwards of 10% of women developing some degree of vaginal vault prolapse after enduring one. In vaginal vault prolapse, the top of the vagina falls toward the vaginal opening. This may cause the walls of the vagina to weaken as well. As this condition progresses  the top of the vagina may protrude out of the body through the vaginal opening, effectively turning the vagina inside out.
Risk Factors of Pelvic Organ Prolapse
Risk factors of pelvic organ prolapse include the following:
- Pregnancy
- Menopause
- Hysterectomy
- Advanced age
- Obesity
- Dysfunction of the nerves and tissues
- Abnormalities of the connective tissue
- Strenuous physical activity
- Prior pelvic surgery
What you should know about Pelvic Organ Prolapse Symptoms
- Approximately 30%-40% of women develop some form of pelvic organ prolapse in their lifetime. This is usually following menopause, childbirth, or a hysterectomy.
- Most women who develop this condition are older than 40 years.
- Many women who develop symptoms of a prolapse do not seek medical help because of embarrassment or other reasons.
- Some women who develop a prolapse do not experience symptoms.
Any woman who experiences symptoms that may indicate a prolapse should contact her doctor. A prolapse is rarely a life-threatening condition. However, prolapses do gradually worsen. As a result, timely medical care is recommended to evaluate for and to prevent problematic symptoms and complications caused by weakening tissue and muscle in the vagina.
The Cosmetic Gynecology Suite is the only surgical unit of its kind in the world. Here Vaginoplasty, Labiaplasty, hymen reconstruction or modification and total functional vaginal and pelvic reconstruction can be done in conjunction with other cosmetic procedures.
There are a number of procedures that can be done on the vagina depending on what the patients vaginal problems are. Contact our Vagina and Labia Plastic Surgery Specialists to provide you with the knowledge and medical expertise you need to make the correct decisions.
To schedule a consultation call The Cosmetic Gynecology Suite at 212-772-1300.
