RECOGNIZE THE SIGNS AND TAKE THE RIGHT ACTION.

Vaginal prolapse: what to do to regain support.

Vaginal prolapse: what to do to regain support.

What is vaginal prolapse? Are there signs that you may be affected? And if so – what options does Asst. Prof. Dr. Resmiye Ermis offer to help you regain a carefree life? Read the answers and more here.

Brief overview: vaginal prolapse – what lies behind it?

The vagina is a very flexible structure that can adapt remarkably well, for example during childbirth. If it can no longer maintain its natural position and may even shift downward, this is referred to as vaginal prolapse (descensus vaginae).

Because humans walk upright, the birth canal is oriented downward with its opening facing below. It is supported by the bony pelvis, the pelvic floor muscles, and connective tissue. Training the pelvic floor muscles even before symptoms occur is therefore generally a good idea. Likewise, paying attention to proper lifting techniques when handling heavy loads is important.

Four degrees of vaginal prolapse are distinguished:

Grade 1: slight descent of the organs.
Grade 2: descent of the organs down to the vaginal opening.
Grade 3: the vagina or uterus protrudes up to 1 cm beyond the vaginal opening.
Grade 4: the vagina or uterus protrudes to a large extent beyond the vaginal opening.

On average, vaginal prolapse is diagnosed around 30,000 times per year. However, most cases involve only mild descent. What physical signs may be present?

Because the vagina is closely connected to other organs such as the bladder or the bowel, numerous functions can be impaired as a result of vaginal prolapse.

The bladder is often affected, with symptoms such as stress incontinence or increased urinary urgency. However, due to kinking of the urethra, the opposite can also occur, namely impaired bladder emptying. A vague feeling of pressure in the pelvic area, a foreign body sensation in the vagina, or back pain are additional symptoms. Bowel movements can also be affected by descent of the posterior vaginal wall, ranging from difficulties with defecation to fecal incontinence.

In addition, sexual life often suffers as a result of vaginal prolapse due to pain during intercourse. These symptoms are frequently accompanied by psychological distress. What are the underlying causes?

During childbirth, the vagina can be subjected to extreme stretching. This can result in damage to the supporting structures and the vaginal musculature, for example when muscle fibers and connective tissue tear or nerves are overstretched. As a consequence, the vagina may descend.

A heavily strained pelvic floor also contributes to vaginal prolapse, for example due to chronic pressure from the abdominal organs. The urethra, bladder, rectum, and uterus can all be affected, as they lie directly against the vaginal wall. Severe overweight and smoking also promote the development of vaginal prolapse. And with increasing age, connective tissue and muscles weaken without regular training, which can cause the supporting structures to lose stability.

If there are possible signs, how does Asst. Prof. Dr. Ermis provide you with clarity?

An examination is the first step. By palpating the organs in the abdomen and the posterior part of the pelvis, Asst. Prof. Dr. Ermis already gains essential indications. Ultrasound can then be used to assess changes in the position of the urethra, bladder, vagina, uterus, and bowel in greater detail. In some cases, it may also be useful to evaluate the bladder’s storage function. X-ray or MRI examinations, however, are usually only necessary in complex cases.

If conservative approaches have been exhausted, Asst. Prof. Dr. Ermis generally operates via the vagina. The vaginal wall is separated from the underlying layer and tightened. The bladder base is cushioned and elevated. What is special about this minimally invasive procedure performed by Asst. Prof. Dr. Ermis is that the otherwise common incision of the vaginal wall is not required. Neither vaginal sutures nor vaginal packing are necessary. Healing is therefore not only faster, but pain is also significantly reduced. And afterwards?

The vagina and possibly other organs are once again securely supported within the body. Pain and physical limitations are a thing of the past, and normal life has returned with renewed joy. Thanks to the minimally invasive expertise of Dr. Resmiye Ermis, healing has occurred significantly faster than with conventional methods.

When will the time be right for you to leave the symptoms of vaginal prolapse behind and live life without limitations again? Take action now. Schedule your appointment and speak woman to woman with Asst. Prof. Dr. Ermis about your options: 069-407 15 50. Or send a message to gynaekologie@rotkreuzkliniken.de.

Pelvic floor prolapse:

This is how organ support can be restored.

Pelvic floor prolapse:

This is how organ support can be restored.