What is a vaginal (pelvic organ) prolapse?
Your pelvic organs include your bladder, uterus (womb) and rectum (back passage). These organs are held in place by tissues called ‘fascia’ and ‘ligaments’. These tissues help to join your pelvic organs to the bony side walls of the pelvis and hold them inside your pelvis.
Your pelvic floor muscles also hold up your pelvic organs from below. If the fascia or ligaments are torn or stretched for any reason, and if your pelvic floor muscles are weak, then your pelvic organs might not be held in their right place and they may bulge or sag down into the vagina.
Relaxation of the vaginal tissues called pelvic floor relaxation syndrome (PFRS) subsequently leads to prolapse of the vaginal walls and bladder or rectum. Although it can be a natural ageing phenomenon pregnancy and vaginal delivery are major contributing factors.
Other factors that may influence the occurrence of relaxation are obesity and lack of appropriate muscular exercises.
The PFRS becomes most evident during menopause when hormonal changes cause the tone of vaginal and pelvic floor muscles to decrease and the vaginal mucosa to get thinner. The PFRS manifests itself through vaginal and uterine prolapse of different severity, decrease of vaginal elasticity or widening of the vagina which is progressive with age.
Some questions you may have
What are the symptoms of PFRS ?
- Unpleasant sensations in the perineum (stretching, pulling and “ something dragging down”)
- Pain in the area of the sacrum (disappears after lying down)
- Painful and unpleasant sexual intercourse
- Stress urinary incontinence or inability to urinate
- Vaginal and uterine prolapse (the woman touches it or sees it)
- Recurrent urinary system inflammations
- There might be no symptoms
How is vaginal prolapse treated?
As with most medical conditions, conservative approaches are employed first, primarily pelvic floor exercises designed to strengthen the muscles in the entire region. Women whose age or physical condition may prohibit exercise may be fitted with a pessary, a vinyl ring inserted in the vagina to hold the prolapse in place.
Surgical Treatment Options
If conservative measures fail, your physician may recommend surgery to help fix vaginal prolapse. The degree of prolapse and anatomical conditions will affect decision as to which surgical procedure to pursue. For instance, a hysterectomy (removal of the uterus) may be required when significant prolapse is present.
Laser Treatment Option
Aesthetic Gynaecology has been one of the fastest developing medical specialties in recent years. One of the most advanced technologies used in genital rejuvenation are treatments with lasers. Laser rejuvenation has already proved to be successful in the treatments of various gynaecological conditions including Pelvic Floor Relaxation Syndrome (PFRS) and genital prolapse. As the evidence of satisfactory outcome of such treatments grows lasers are becoming an attractive non-surgical treatment option for many women troubled by chronic genitourinary problems including vaginal prolapse. CO2 fractional lasers are used in treating mild and sometimes moderate prolapse in many countries worldwide. Women who have large prolapse are not suitable for CO2 laser treatment due to the advanced changes in the pelvic floor and vaginal anatomy. These women are likely to benefit more from pelvic floor surgery.
The Intima laser treatment of vaginal prolapse is carried out with the internal vaginal probe the same way as other treatments of the vaginal canal, but with the use of a slightly different setting allowing maximum treatment intensity to be adjusted for individual patients.
Even when using the high power of the laser beam the treatment remains safe, well tolerated and is practically painless.
Thus, the advantages of innovative laser treatment are: minimally invasive, painless, stimulating the formation of new collagen and selective reconstruction of collagen in a weakened and aged vaginal wall. Such minimally invasive technologies in some patients can be considered as an alternative to surgical treatment of pelvic floor dysfunctions.