Uterine and Vaginal Prolapse Consultation

Uterine or vaginal wall prolapse is a condition in which the uterus or one of the vaginal walls descends from its normal position and can protrude into or even out of the vagina.

This condition can affect women of different ages, but is most common after the menopause, childbirth or due to a chronic increase in abdominal pressure.

The Uterine Prolapse and Vaginal Prolapse Consultation aims to provide an accurate diagnosis, assess the severity of the prolapse and discuss the most appropriate treatment options.

Symptoms

The symptoms of uterine or vaginal prolapse can vary according to the degree of prolapse, but the most common include:

• Feeling of pressure or heaviness in the pelvis or vagina.
• Discomfort or pain during sexual intercourse.
• Difficulties urinating or defecating, including the sensation of incomplete emptying.
• Visibility or sensation of a "ball" at the entrance to the vagina.
• Lower back pain.
• Increased vaginal flow.

Causes

Uterine and vaginal prolapse can be caused by various factors, often related to the weakening of the pelvic muscles, ligaments and supporting tissues:

• Pregnancy and vaginal childbirth, especially multiple or with complications.
• Ageing and decreased oestrogen levels after the menopause.
• Chronic exertion, including persistent coughing, constipation or heavy lifting.
• Genetic factors or a hereditary predisposition to weak connective tissue.
• Obesity, which increases pressure on the pelvic muscles.
• Smoking.

Diagnosis

Diagnosis of uterine or vaginal prolapse usually involves:

• A detailed anamnesis and physical examination, including a pelvic examination to assess the extent of the prolapse.
• Additional tests, such as pelvic ultrasound, can be carried out to assess the condition of the pelvic organs and the severity of the prolapse.

Treatment

Treatment for uterine and vaginal prolapse depends on the severity of the symptoms and the patient's wishes:

• Observation, in cases of mild prolapse without significant symptoms.
• Pelvic floor strengthening exercises, such as Kegel exercises, to improve support for the pelvic organs.
• Use of support devices, such as a pessary, which is inserted into the vagina to support the uterus and vaginal walls.
• Hormone replacement therapy, particularly in postmenopausal women, to strengthen the tissues in the pelvic region.
• Surgery, considered in more serious cases or when other treatments have not been effective, which may include pelvic tissue repair or, in specific situations, hysterectomy.

Prevention

Although not all cases of uterine and vaginal prolapse can be prevented, some measures can reduce the risk:

• Regularly practising exercises to strengthen the pelvic floor.
• Maintaining a healthy weight to reduce pressure on the pelvic organs.
• Avoid lifting excessive weights and treat chronic coughing or constipation to reduce the strain on the pelvis.
• Weight gain during pregnancy in accordance with your doctor's recommendations.
• Smoking cessation.

The Uterine and Vaginal Prolapse Consultation is fundamental to ensuring that the patient receives the correct diagnosis and the appropriate treatment for this condition and her particular case, in order to significantly improve her quality of life.