Genital prolapse is a general term referring to several conditions that may occur separately or in combination. These include a uterine prolapse (dropped womb), a vaginal prolapse, a cystocele (dropped bladder), a rectocele (dropped rectum), and an entrocele (herniation of the small intestine into the space between the rectum and vagina).
Causes of a Prolapsed Uterus
A uterine prolapse occurs when the uterus drops from its normal position. The cervix may descend into the vaginal opening. This condition affects approximately 11% of all women, usually in the post menopause years. However, it also occurs in young women and it may be caused by the childbirth of a large baby when the vaginal walls are damaged.
Multiple deliveries may also weaken the area and lead to a uterine prolapse. Other causes include constipation, obesity, and fibroid tumors. Sometimes in menopause the ligaments which hold the uterus in place lose some elasticity and strength due to reduced estrogen levels and this may lead to a uterine prolapse.
Symptoms of a Prolapsed Uterus
The symptoms of uterine prolapse usually include a feeling of pelvic bulging, heaviness or fullness, and/or lower back pain. These symptoms may worsen with activity and improve with bed rest. When standing, women with a prolapse actually feel as though something is falling out. Other symptoms may include vaginal pain or discharge, incontinence or difficulty urinating, bladder infections, or anal pain.
Pessaries are used to alleviate these symptoms. Not only do pessaries assist in restoring continence by stabilizing the bladder base, they can support the pelvic organs in their proper anatomic position in women who have a prolapse, cystocele, or rectocele. In women who are not interested in surgery or in women who are not good surgical candidates, pessaries offer a very viable treatment option.
Frequently Asked Questions
- Will I always have to use this pessary?
Not necessarily. Your vaginal muscles may strengthen to the extent that the pessary is no longer needed. Sometimes pessaries are only required for strenuous activity.
- Can a pessary hurt or become uncomfortable?
A properly fitted pessary never causes pain or discomfort.
- How often should I remove the pessary?
It is recommended that you remove the pessary daily to clean it using a mild soap and water. If you have difficulty removing it, make an appointment with your healthcare provider for removal and cleaning. Don't be alarmed if the appointment is weeks away. Pessaries can remain in place from 4 to 12 weeks.
- What is my responsibility?
Your responsibility is to follow your healthcare provider's instructions, wear your pessary, and keep all the follow-up appointments.
- Will my pessary set off the alarm at the airport?
- Can I have sex with my pessary in place?
Yes, you can. If you want to remove it, then do so.
- Will the pessary prevent pregnancy?
- Can my pessary fall out?
Yes, it can. If your pessary is too small or you need a different type, sometimes it will fall out. Simply clean and reinsert it. If this persists, call your healthcare provider and make an appointment for a different type of pessary.