Vaginal Prolapse

Vaginal prolapse is one of several effects that could occur due to weakness of the pelvic floor. This “floor” holds the pelvic organs in place, and when its muscles weaken, these organs, including the vagina, could gradually prolapse downwards. At severe stages of this effect, the vagina could protrude beyond the vulva, the opening of the female genitalia.

The vagina is a cylindrical organ, several centimeters long, located between the cervix and the vulva, in close proximity to the rectum. Vaginal prolapse is not a life-threatening occurrence, but it can certainly impair the normal conduct of life, and of course, cause much embarrassment to those suffering from it. In its early stages, the prolapse will not always be noticed and will not cause clear unequivocal symptoms, but in the advanced stages, it can impair continence, make it difficult to empty the bowel and the urinary bladder, cause a sensation of general pressure in the pelvic area and back pain, cause vaginal bleeding and more.

The direct causes of vaginal prolapse are currently not exactly known, but multiple vaginal deliveries, lifting of heavyweights, age-related weakening of muscles and also genetics are considered to be the main factors that contribute to the generation of such a condition.

The condition can be treated conservatively if it is not severe, but if it is a severe and prolonged condition, the treatment will generally be surgical.

General information about vaginal prolapse surgery

Vaginal prolapse surgery is performed when conservative treatments are not effective, or in cases where the condition is discovered at very advanced stages – stages at which the lifestyle impairment is very great, and there is no way of restoring the situation to what it was by other methods.

The operation is usually performed under regional or local anesthesia. In the past, these operations were performed by an open approach, via an incision made in the lower abdomen, but today, many are performed by vaginal approach, via the vagina itself. Only if there is a problem that necessitates treatment of additional organs will the operation be performed via the lower abdomen.

Is should be noted that in many instances, vaginal prolapse indeed does necessitate treatment of adjacent organs: the uterus and the urinary bladder, for example, also tend to prolapse when vaginal prolapse occurs. However, there are instances in which only the vagina prolapses downwards.

In either case, since it is the internal organ that is closest to the vulva, the effect of vaginal prolapse on the woman’s function is the most significant in most cases.

Preparing for the procedure

Since most operations are not performed under general anesthesia, there is no need for significant preparation prior to the operation in this regard. You might undergo various examinations before the operation to assess the condition of other pelvic organs, such as urodynamic examination and a test to identify urinary tract inflammation. These examinations will confirm that you are physically ready to undergo the operation.

The course of vaginal prolapse surgery

Vaginal prolapse surgery is performed, as mentioned above, under local or regional anesthesia. It can also be performed under general anesthesia is you so desire. The course of the operation will be determined in accordance with your physical condition and your wishes: if you plan to give birth in the future, an operation to strengthen and “stretch” the pelvic floor will be performed after the vagina is returned to its place. The partition between the vagina and the rectum will also be strengthened, and at times, cosmetic procedures will also be performed in the framework of this operation, to restore the vagina to its original shape (these would be performed particularly after multiple deliveries). An additional important procedure performed in the framework of this operation: strengthening of the vaginal wall, which will reduce the chance for recurrence of the condition in the future.

If you do not intend to give birth in the future, you may undergo an operation to close the vagina, which will prevent it from protruding beyond the vulva. This operation will usually be performed at a relatively older age. It should be noted that after the operation, you will also not be able to have full sexual intercourse.

Since this operation usually does not require a large surgical incision to be made, recovery from it is quite rapid. You may expect to be discharged to your home within two days at the most, and already after two weeks, you will be able to return to your normal routine, more or less, with two main limitations: Firstly, that you must not lift heavy weights for the first six weeks after the operation. Secondly – you will not be able to have sexual intercourse until eight weeks after the operation (this time interval may vary depending on your physician’s advice). The first time you have full sexual intercourse after the operation, there may be some vaginal pain.

Furthermore, during this period, it is very important to avoid constipation, and it is therefore recommended to drink plentiful fluids throughout this period.

Side Effects

There are some very rare side effects connected to vaginal prolapse surgery: bleeding and infection, perforation of the urinary bladder, perforation of the bowel, damage to the ureters and entrapment of the sciatic nerve, which could cause pain in the rear. We again emphasize that these side effects are quite rare, as the operation is relatively simply and not particularly complicated.