Pelvic Floor Prolapse
Removing the uterus, going through childbirth and going through menopause can weaken your pelvic floor and the network of muscles and ligaments holding your pelvic floor organs in place. Learn about the symptoms of pelvic floor prolapse and take action.
The network of muscles and ligaments surrounding the vagina may weaken and cause the pelvic floor to collapse. There are different types of pelvic floor prolapse.
Vaginal Vault Prolapse
The top of the vagina may fall towards the vaginal opening. A herniated small bowel is often involved as the front and back walls of the vagina separate and the intestines can push against the vaginal skin. Many women develop vaginal prolapse, usually following menopause, childbirth or a hysterectomy. The uterus provides support to the pelvic floor and as it is removed, can result in the weakened state of the network of support.
Prolapse of the Bladder - Cystocele
If the front of the vaginal wall collapses, the result is a bladder prolapse. Often it is accompanied by a prolapse of the urethra. A common symptom of bladder or urethra prolapse is urinary stress incontinence which is a leaking of urine involuntarily.
Prolapse of the Rectum - Rectocele
When the back wall of the vagina weakens, it pushes against the vaginal wall, causing a bulge which may be noticeable during bowel movements.
If you are experiencing any of the symptoms of a pelvic organ prolapse, it is important to visit your doctor for a complete assessment.
Treatment will depend on your particular circumstances but may include medications, physical therapy or surgery. Check with your personal physician.
When to Talk to Your Doctor
Most women are hesitant to talk to their doctor about a leaking bladder or a bulge in their vagina during bowel movements, and yet these are the exact symptoms that should encourage you to seek a medical opinion.
Suffering with embarassment or delaying a consult with your doctor will only delay your comfort and repair.
Call and make an appointment with your doctor if you experience any of these symptoms:
- Pressure in the vagina or pelvis
- Pelvic discomfort
- Urinary or bowel dysfunction
- A decrease in pain or pressure when lying down
- A lump at the opening of the vagina
- Recurrent urinary tract infections
- Sexual dysfunction
- Painful intercourse
- Back pain
- Urinary Incontinence
Steps to Action
If you are concerned about any symptoms noted above, schedule a doctor appointment right away.
Take a list of symptoms you are experiencing including specific examples of your concerns. (Example: Every time I sneeze, I leak urine and need to change my clothes. Or: Whenever I am having a bowel movement, I feel a lump at the opening of my vagina.)
Your doctor may take images using MRI, ultrasound or cystourethroscopy to diagnose your condition. Other tests such as a bladder function test or a pelvic floor strength test may also be given to you to thoroughly understand your complaints and create a plan of action.
Some pelvic floor conditions may be treated with physical therapy or medications. Other pelvic floor prolapses must be treated with surgery. Laparoscopic surgery is one option that is minimally invasive and can correct the condition in most cases.
Often, following pelvic surgery and the use of a catheter, you may experience bladder spasms.
In most cases, the spasms are mild and will disappear given time for the bladder to adjust to the removal of the catheter.
If you find your bladder spasms are keeping you awake or adding additional pain to your discomfort, make sure to mention the spasms to your doctor with specific details on when you experience them, how often and length of the pain.
The sudden onset of urine leaking following a surgery in the pelvic area can signal a fistula. A bladder fistula is leakage from the bladder to the vagina. Although rare, this is a complication seen in some pelvic surgeries including a hysterectomy. An initial exam usually includes a visual exam with a speculum. Diagnostic tools include dye tests, cystoscopy, retrograde pyelograms, fistulagrams and other imaging studies. Your doctor can determine if surgery is necessary.
Some simple fistulas may respond to constant bladder drainage for at least 4 weeks to give the bladder a chance to heal. Or, for simple rectovaginal fistulas, the patient may be asked to modify their diet and use fiber supplements.
Most fistulas require surgery to repair the damage but often is not scheduled until the body is allowed to try to heal on its own.
Many women experience urinary incontinence which is an involuntary loss of urine. Some women lose a few drops while running or coughing. Others may feel a sudden urge to void followed by a large loss of urine. Women experience urinary incontinence twice as often as men usually following childbirth, menopause or after a hysterectomy. Click here to read more about stress incontinence
Incontinence occurs because of problems with muscles and nerves that help to hold or release urine.
If you are experiencing urinary incontinence, talk to your doctor. There are treatment options!
Urinary Tract Infections (UTI)
A urinary tract infection is a bacterial infection that may affect any part of the urinary tract. The urinary tract includes the kidneys, ureters, bladder and urethra. Bladder and urethra infections are the most common.
- A burning sensation when you urinate
- Feeling like you need to urinate more often than usual
- Feeling the urge to urinate but not being able to void
- Leaking a little urine
- Cloudy, dark, smelly or bloody urine
If you have urinary tract infections that do not seem to clear up with the prescribed treatment, you may be experiencing Interstitial Cystitis.
Interstitial cystitis is chronic inflammation of the bladder. Women who have interstitial cystitis have a bladder wall that is inflamed and irritated . This inflammation can scar the bladder or make it stiff. A stiff bladder can't expand as urine fills it. In some cases, the walls of the bladder may bleed slightly and some women get sores in the bladder walls.
If you have been struggling with a presumed UTI that will not go away, ask your doctor about Interstitial cystitis which has many of the same symptoms.
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