Among older woman, pelvic organ prolapse is a very common condition with as many as half the women who have children experiencing it in some form. However, it is impossible to be certain of the actual number affected because so few will not seek help from their doctor for this embarrassing and distressing problem.
However, prolapse is not exclusive to women and, whether you are male or female, some form of prolapse can occur if the Pubococcygeus muscle, which is like a sling that runs between your legs from your spine to your pubic bone, has become too slack and is not supporting the pelvic organs properly, allowing any one of them to slip out of its normal position.
The most worrying thing is that this lack of tension can be caused by many factors - childbirth, Menopause, obesity, the general wear and tear of getting older can all be contributors - and the most important thing that any woman can do to reduce the risk of suffering from uterine, vaginal, urethral, bladder or rectal prolapse or to prevent a mild prolapse from worsening is Kegel and pelvic floor exercises.
This applies to males as well as females, if they want to keep their rectum and intestines in place. If they don't exercise their pelvic diaphragm regularly, then men can also be subject to prolapse. As they age, if not worked at, the Pubococcygeus muscle will stretch and sag to varying degrees, risking rectal prolapse. If obesity is also a factor then the odds increase significantly.
Some people have no idea that they have suffered a mild prolapse but any symptoms that do occur will give a clue as to which organ is causing the problem.
Various muscles and ligaments attach the rectum to the pelvis but childbirth, constipation, age, obesity and sometimes even haemorrhoids can weaken them. In less severe presentations, only the lining of the rectum hangs out of the anus so it needs to be ascertained if this is actually haermorrhoids or a true prolapse. As things worsen, the ligaments become more and more stretched until part of the rectum itself can be felt protruding from the anus. Other symptoms can include constipation or diarrhoea or the inability to defecate at all.
For women, there are additional forms of rectal prolapse called rectocele and enterocele. The latter is a prolapse of the small bowel, where part of the small intestine that lies just behind the uterus may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or a uterine prolapse.
A rectocele is a prolapsed rectum that can result when the back side (or posterior) wall of the vagina prolapses. This can sometimes be diagnosed through a patient complaining about 'not feeling clean' due to some of the matter becoming caught around the prolapse. For some women, it may even be possible to place a finger into the vagina and push the bowel back into place.
The most common type of prolapse for women is cystourethrocele, which is when the bladder and the urethra (the tube which carries urine from the bladder out of the body) prolapse together. The bladder falls towards the vagina and creates a large bulge in the front vaginal wall.
When the urethra slips out of place, it also pushes against the front of the vaginal wall, but lower down, near the opening of the vagina.
If you are leaking urine or feel an urgent need to pee frequently or cannot go at all, then this could indicate a bladder or urethra prolapse.
Uterine prolapse is when the womb drops down into the vagina. It is the second most common type of prolapse and is classified into three grades depending on how far the womb has fallen. It may be indicated by a pulling heaviness in the pelvic area and the feeling that something is falling out.
The vaginal vault is the top of the vagina and this can only fall in on itself after a woman's womb has been removed (hysterectomy).
Certain symptoms that can occur with all types of prolapse are feeling a lump or heavy sensation in the vagina; lower back pain that eases when you lie down; pelvic pain or pressure; pain or lack of sensation during intercourse.
You should visit your healthcare provider immediately if you experience any of these symptoms.
Kegel and pelvic floor exercises - because prevention is always better than cure.
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