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Vaginal Prolapse (cont.)

Vaginal Prolapse Medications

Estrogen replacement therapy may be used to help the body strengthen the muscles in and around the vagina. Estrogen replacement therapy may be contraindicated (such as in a people with certain types of cancer) and has been associated with certain health risks including increased risk of blood clots and stroke, particularly in older postmenopausal women. Women's bodies cease producing estrogen naturally after menopause, and the muscles of the vagina may weaken as a result. In mild cases of vaginal prolapse, estrogen may be prescribed in an attempt to reverse vaginal prolapse symptoms, such as vaginal weakening and incontinence. For more severe prolapses, estrogen replacement therapy may be used along with other types of treatment.

Vaginal Prolapse Surgery

A generalized weakness of the vaginal muscles and ligaments is much more likely to develop than are isolated defects. If a woman develops symptoms of one type of vaginal prolapse, she is likely to have or develop other types as well. Therefore, a thorough physical examination is necessary for the surgeon to detail what surgical steps are necessary to correct the vaginal prolapse completely. The typical surgical strategy is to correct all vaginal weaknesses at one time.

Surgery is usually performed while the woman is under general anesthesia. Some women receive a spinal or epidural. The type of anesthesia given usually depends on the anticipated length of the surgical procedure.

Laparoscopic surgery is a minimally invasive surgical procedure that involves slender instruments and advanced camera systems. This surgical technique is becoming more common for securing the vaginal vault after a hysterectomy and correcting some types of vaginal prolapse such as enteroceles or uterine prolapses.

  • Vaginal vault prolapse: This is a defect that occurs high in the vagina, so it may be approached surgically through the vagina or abdomen. Generally, the abdomen is the entry of choice for a severe vaginal vault prolapse. This corrective surgical procedure usually involves a technique called a vaginal vault suspension, in which the surgeon attaches the vagina to strong tissue in the pelvis or to a bone called the sacrum, which is located at the base of the spine.
  • Prolapsed uterus: For women who are postmenopausal or do not want to have more children, a prolapsed uterus is usually corrected with a hysterectomy. The common approach for this procedure is through the vagina.
  • Cystocele and rectocele: These are usually corrected through the vagina. Typically, the surgeon makes an incision in the vaginal wall and pushes up the organ. The surgeon then reinforces the tissues beneath the vaginal wall to restore the organ to its normal position. Any excess tissue is then removed, and the vaginal wall is closed. On occasion, the surgeon may elect to use a surgical procedure called a laparoscopic bladder suspension, or modified Burch procedure, to correct a cystocele. If urinary incontinence is present, the surgeon may need to support the urethra (bladder neck suspension).

Women who undergo surgery for vaginal prolapse repair should normally expect to spend 2-4 days in the hospital depending on the type and extent of the surgical. After surgery, women are usually advised to avoid heavy lifting for approximately 6-9 weeks.

Medically Reviewed by a Doctor on 1/11/2016
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Read What Your Physician is Reading on Medscape

Enterocele and Massive Vaginal Eversion »

Massive vaginal vault prolapse (uterovaginal prolapse) is a devastating condition with discomfort and genitourinary and defecatory abnormalities as the primary consequences.

Read More on Medscape Reference »


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