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Vaginal Vault Prolapse

Compassionate care for a woman’s vaginal health

For urological-related conditions specific to women, the professionals at The Urology Center of Colorado are equipped to provide counsel and treatment in a warm, comforting setting. TUCC meets the needs of women—and one of those needs is in the area of vaginal vault prolapse.

What Is Vaginal Vault Prolapse?

Vaginal vault prolapse occurs when a woman’s pelvic floor muscles and ligaments are stretched and/or weakened, causing the pelvic organs, such as your bladder, to sag into the vagina. In severe cases, the bladder can appear at the vagina’s opening or protrude through it. Women who have had multiple pregnancies and deliver children vaginally are at a higher risk for prolapse. It is most common in people who have had multiple vaginal deliveries and gone through menopause.

Prolapse occurrences can be large or small. A smaller vaginal prolapse is known as an incomplete prolapse. A large prolapse incident occurs when the organ shifts significantly. In this severe prolapse, the bladder protrudes from the vagina.

What Causes Vaginal Vault Prolapse?

Muscles and tissue within the pelvis hold your organs in place. As you age, the body weakens and, over time, this structure can become compromised. Meanwhile, other physical incidents can potentially bring about a prolapse. 

These are the most common causes of a vaginal vault prolapse:

  • Age: Your risk for experiencing a prolapse increases as you age.
  • Childbirth: Multiple vaginal deliveries increases the risk of a prolapse.
  • Menopause: During menopause, your body stops producing certain hormones, including estrogen. Estrogen helps keep pelvic muscles strong. When your body doesn’t produce as much estrogen as it once did, it increases the risk of a prolapse. 
  • Surgery: Patients who have had a hysterectomy (uterus removal) are more likely to experience a vaginal prolapse. 
  • Strain: Extreme physical exertion or lifting heavy objects can weaken your pelvic muscles.
  • Family history: Genetics or hereditary factors could increase your risk of a prolapse.

Symptoms of Vaginal Vault Prolapse

A vaginal vault prolapse presents several symptoms. If you experience any such symptoms, make an appointment with a TUCC physician. Symptoms include:

  • Pelvic heaviness
  • Lower back pain
  • A bulging mass protruding from the vagina
  • Urinary incontinence
  • Constipation
  • Vaginal bleeding
  • Problems with sexual intercourse
  • Difficulty inserting tampons

What Does a Vaginal Prolapse Feel Like?

If the vaginal vault prolapse is mild, you might not feel anything at all. In this case, a TUCC physician might discover a mild prolapse during an examination. In more severe cases, you might have the sensation that a ball or mass is hanging from your vagina. You might also feel pain when urinating or during sexual intercourse.

Diagnosing Prolapse

Vaginal prolapse is diagnosed during a physical examination. Your urologist will review any symptoms you are experiencing and may run tests to determine the severity of the condition. In most cases, your provider can feel a prolapse by inserting a gloved finger in your vagina or upon a visual inspection of the area.

If you are experiencing trouble with urination, your TUCC physician may order tests to check your bladder function. They may also order an MRI (magnetic resonance imaging) or pelvic ultrasound if they need a better view of the other pelvic organs.

VVP Treatments

Treatments for vaginal vault prolapse vary depending on the severity of the case. For cases on the mild side, your physician may suggest monitoring the prolapse to ensure it doesn’t progress to a severe prolapse. 

For mild to severe cases, there are nonsurgical and surgical treatment options. TUCC can provide guidance through all such treatment plans, taking into account your age, health history, and other factors. These treatments include: 

Kegel Exercises

Designed to strengthen the pelvic floor muscles, Kegel exercises are recommended for mild prolapse cases. This exercise involves tightening the pelvic muscles and holding the contraction for 5–10 seconds at a time. A pelvic floor exercise such as Kegels can potentially improve mild-to-moderate cases of prolapse; however, it is best to consult a physician at TUCC for a full evaluation and to discuss the best treatment options. 

Physical Therapy 

TUCC believes in comprehensive physical therapy following treatment for Vaginal Vault Prolapse. For a multitude of physical therapy techniques—including orthopedic manual physical therapy, individualized exercise programs, stress reduction techniques, education, and healthy lifestyle instruction—TUCC refers patients to: 

N2 Physical Therapy
https://n2physicaltherapy.com/

Louisville Office:

louisville@n2physicaltherapy.com
335 W South Boulder Rd., Suite 1
Louisville, CO 80027
T: 303-954-8423
F: 720-302-0150

Centennial Office:

centennial@n2physicaltherapy.com
6909 S. Holly Circle, Suite 100
Centennial, CO 80112
T: 720-389-8730
F: 720-302-0150

Uptown Office:

denver@n2physicaltherapy.com
1888 N Sherman St., Ste 202
Denver, CO 80203
T: 720-583-0439
F: 720-302-0150

Pessary Placement 

A pessary is a device that is placed inside your vagina and acts as a support structure to hold everything in place. Shaped like a small plastic or rubber ring, a pessary is placed inside of your vagina by a healthcare provider, but it is up to the patient to clean the device frequently and remove it before engaging in sexual intercourse. Once again, it is best to consult your physician at TUCC to gauge whether or not this is a proper treatment for your condition. 

Robotic Surgery

In more severe prolapse cases, a robotic sacrocolpopexy may be recommended to correct the anatomical position of the vagina or uterus. With this procedure, mesh is used to hold the vagina in the correct anatomical position. Robotic sacrocolpopexy offers patients significantly less pain, reduced blood loss, less risk of infection, shorter hospital times and faster recovery. TUCC surgeons lead the region in performing urologic robotic surgery, having performed more than 5,000 procedures since 2006.

Doctors

FAQ

This is a procedure that corrects the anatomical position of the vagina or uterus. It involves attaching a piece of mesh to your vagina and securing the mesh to your tailbone to give the vagina a lift. This surgery is done through your abdomen, using small incisions and a minimally invasive surgery called laparoscopy.

It is a good idea to sit on soft, cushiony surfaces after prolapse surgery. It is also recommended to use a donut pillow to relieve any discomfort when in the seated position.

It’s a good idea to avoid driving for one-to-two weeks following prolapse surgery. Your TUCC physician can give you the best insight into when you can return to daily activities.

You can go up and down stairs following surgery, but limit the amount of times you climb stairs for the first two weeks, and try not to climb extremely long staircases for about four weeks.

For mild to moderate cases of vaginal prolapse, there are nonsurgical treatment options you can discuss with your TUCC physician. For more severe cases, surgery is often recommended.

Vaginal prolapse is relatively common, with about 1/3 of women experiencing some degree of prolapse during their lifetime.

A vaginal vault prolapse that goes untreated can cause an array of health concerns. For example, an untreated prolapse can lead to sores on the cervix, which increases the chance of infection or injury to other pelvic organs.

While there are some steps one can take to prevent prolapse—such as regular Kegel exercises, a healthy diet, and regular bowel movements—the best way to prevent prolapse is regular examinations by physicians at TUCC.

We’re here to help.

For appointments at any TUCC location, request an appointment online.