Genital prolapse, more frequently called organ descent, is a minor pathology that occurs in cases of fragility of the perineum. While it is becoming more common in older women, genital prolapse can also affect younger women, particularly after vaginal delivery, the use of forceps or a midline episiotomy. Symptoms, diagnosis and treatments, overview of possible solutions to avoid it.
What is genital prolapse?
Genital prolapse, commonly called organ descent, is characterized by the sliding of one or more pelvic organs into the vagina, causing an unpleasant feeling of heaviness. There are three types of prolapse, depending on the organ concerned: hysteroptosis for the uterus, cystocele for the bladder and rectocele for the rectum. Initially, the pelvic organs just press on the vaginal wall, then they gradually descend until they emerge outside the vulva in some cases.
Possible causes of organ descent
The pelvic organs are normally held together by the muscles of the perineum and ligaments. When this support system is weakened, when the muscles and/or ligaments relax, organ descent can occur. “During the consultation, the gynecologist will try to identify certain risk factors that could be corrected because prolapse is often multifactorial. It is due to age, aging of tissues, history of childbirth and episodes of constipation repeated. Other factors can cause genital prolapse: a family history of tissue fragility, excess weight, chronic cough, excessive stress on the perineum linked to carrying heavy loads. says Dr Claire Tourette.
The different symptoms of genital prolapse
Some patients are asymptomatic. The characteristic symptom of genital prolapse is a vaginal lump that externalizes, a feeling of heaviness in the vagina. “It’s annoying but painless. Either the patients have objectified it themselves by washing themselves, or they have this feeling of heaviness. They may also be prone to constipation. specifies the gynecologist.
How is genital prolapse diagnosed?
The diagnosis is clinical. It is based on gynecological examination and questioning. “The gynecologist will endeavor to understand what causes this lump: is it a descent of the bladder, the uterus or the rectum through the vagina? Prolapse is linked to a weakness of the tissues which no longer support the weight of the organs. develops our interlocutor. The doctor will then check if there are associated urinary disorders (frequent urge to urinate, urinary incontinence, dysuria) and anorectal disorders (constipation, anal incontinence, if patients must perform reintroduction maneuvers to help with bowel movements). He will also be interested in the sexuality of the patients in order to know if the prolapse causes discomfort during intercourse or constitutes a complex in relation to their body image. “Once we have taken stock of the impact of the symptoms and the clinical examination we will assess the level of discomfort. If the patient is not bothered, it is not serious to have a prolapse. Treatment is not obligatory, it is not dangerous to do nothing in most cases.” continues the specialist.
Treatment: what are the first solutions to put in place?
Treatment essentially depends on the symptoms caused by genital prolapse. If this does not cause any discomfort, treatment is not obligatory. The gynecologist first endeavors to put in place hygienic and dietary rules intended to promote intestinal transit to have a bowel movement, to avoid carrying heavy loads or even to lose weight. Then there are several solutions.
The different treatments for genital prolapse
- The establishment of a gynecological pessary : it is the first-line treatment recommended by the High Authority of Health to support the organs. It can also be put in place while awaiting surgery.
- Perineal rehabilitation with a physiotherapist: it aims to try to compensate for tissue weakness.
- The surgical procedure: functional surgery aims to strengthen the tissues and provide comfort to the patient. It can be performed abdominally (laparoscopy or laparotomy) or vaginally.
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