The network of muscles, ligaments, and skin around a woman’s vagina is a multiplex structure which supports the bladder, uterus, rectum and vaginal vault. Although generally a strong support system, it may weaken and lead to pelvic organ prolapse. Essentially, any one of the aforementioned may fall out of their normal positions.
Susanna was a patient of mine in her seventies who had a vaginal prolapse, a common occurrence in women. I had fitted her with a pessary which is a medical grade silicone device that helps to support a prolapse and works in 80% of women. There are a number of different shapes and sizes depending on the type of prolapse. Pessary fitting is an art not a science which is why experience really counts when fitting pessaries for women. It is important that a pessary is comfortable, does not fall out, and that a woman is able to void. All of this should be checked before a woman leaves the clinic.
Surgery is another option used to treat prolapse but it is not without risks which include:
- Pelvic pair
- Urinary Retention
Many women with pelvic organ prolapse will experience bladder, bowel and/or sexual health issues. Pelvic pressure is common and the feeling of an unwanted bulge between your legs can be very uncomfortable. The types of prolapse are:
- Rectocele – bulge that is especially noticeable during bowel movements
- Cystocele – this can occur when the front wall of the vagina drops; as a result, the bladder may prolapse into the vagina (when this occurs, the urethra usually prolapses as well)
- Enterocele (herniated small bowel) – this primarily occurs following hysterectomy
- Prolapsed uterus (womb falls down) – this can include varying degrees of prolapse:
- First-degree prolapse – Uterus drops into the upper portion of the vagina
- Second-degree prolapse – Uterus falls into the lower part of the vagina
- Third-degree prolapse – The cervix sags to the vaginal opening and may protrude outside
- Fourth-degree prolapse – Entire uterus protrudes entirely outside of the vagina (procidentia)
Susanna loved her pessary as it worked really well supporting her prolapse; however, it did fall out at random times for no apparent reason. She was worried that it may fall out while she was making love with her husband which put a damper on her sexual self-esteem. I suggested that Susanna try RepaGyn®, a hormone free personal moisturizer with healing properties, because she mentioned that things did start to feel a bit dry down there.
When Susanna returned 3 months later for her follow up pessary servicing she was simply delighted – her pessary never fell out this time and she attributed it to her use of RepaGyn®. As I always say, it is just as important to moisturize your vagina as it is your face! Now Susanna could comfortably get back to the bedroom without the worry of something else “popping” up (out)!