February 16, 2019

I feel a vaginal bulge- Are my insides falling out?

Pelvic prolapse is a common complaint in women, especially those who have ever been pregnant. Sometimes, it is something noted by a gynecologist on a yearly exam. Other times, women notice a bulging while in the shower or wiping. Although many women are initially alarmed by this, pelvic prolapse comes in varying degrees and often has little to no impact on a woman’s daily life.

Prolapse is when there is a decrease in strength or a tear in the supportive tissue of the vagina, allowing the nearby organs to bulge into the vagina, especially during bearing down (exercise, coughing, straining for a bowel movement). A bulge in the vagina can be the rectum (rectocele), the bladder (cystocele), the intestines (enterocele), or the uterus. If a woman has had a hysterectomy, the vagina itself can prolapse, bulging into itself. The¬† organs don’t actually come into the vagina, they just push onto the vaginal wall, creating a bulge or ball.

In severe cases, prolapse can cause an uncomfortable pressure sensation, can irritate the vaginal tissues, and can cause bladder or bowel dysfunction. A woman with symptomatic prolapse can try physical therapy or can use a device called a pessary to relieve her symptoms. Pessaries are made of rubber or silicone and come in different sizes and shapes. They are worn in the vagina to hold things in place. Some women use these only during waking hours- others wear them all the time and, if they are not capable of taking them in and out, see a gynecologist for regular removal and cleaning every few months. When conservative measures fail, there are a number of surgeries that can be done for prolapse. However, it is important to refrain from repetitive coughing or heavy lifting after prolapse surgery to minimize the chance of recurrence.

Fortunately, many cases of pelvic prolapse are mild. For these women, who have mild prolapse and minimal to no symptoms, there is no treatment necessary. This is a condition that can be monitored yearly at the Annual Gyn Exam and may never impact a woman’s life.

Tamar Gottfried is a Board Certified Obstetrician/ gynecologist  practicing  general Ob/gyn in Mesa Arizona and affiliated with Banner Desert and Banner Gateway Medical Centers. She can be contacted at 480-545-0059. This is a general interest article only and is not intended to be medical advice. See a medical professional before making medical decisions

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