Cervix Prolapse

Cervix Prolapse

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Vaginal prolapse is a condition where your vagina slips out of position. It happens when the tissues and muscles in your pelvis weaken and overstretch. It’s more common in people who have had multiple vaginal deliveries during childbirth and have gone through menopause.

The American College of Obstetricians and Gynecologists. Pelvic Support Problems. (https://www.acog.org/womens-health/faqs/pelvic-support-problems) Accessed 9/15/2022.
InformedHealth.org [Internet]. Pelvic organ prolapse: Overview. (https://www.ncbi.nlm.nih.gov/books/NBK525783/) 2018 Aug 23. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Accessed 9/15/2022.
Kuncharapu I, Majeroni B, Johnson D. Pelvic Organ Prolapse. (https://www.aafp.org/afp/2010/0501/p1111.html) American Family Physician . May 2010; 81(9): 1111-1117. Accessed 9/15/2022.
Merck Manual Professional Version. Uterine and Apical Prolapse. (https://www.merckmanuals.com/professional/gynecology-and-obstetrics/pelvic-organ-prolapse-pop/uterine-and-apical-prolapse) Accessed 9/15/2022.
The Women’s, The Royal Women’s Hospital Victoria Australia. Vaginal Prolapse. (https://www.thewomens.org.au/health-information/vaginal-prolapse) Accessed 9/15/2022.
Women’s Health Concern. Prolapse: Uterine and vaginal. (https://www.womens-health-concern.org/help-and-advice/factsheets/prolapse-uterine-vaginal/) Accessed 9/15/2022.

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Vaginal prolapse (also called a vaginal vault prolapse) is when the top of your vagina falls from its normal location in your body. Your vagina, also called your birth canal, is the tunnel that connects your uterus to the opening of your vagina. When the top of your vagina becomes weak, the organs that they should be supporting collapse into your vagina, creating the sensation of a lump or bulge.
Your vagina is one of several organs that rests in the pelvic area of your body. These organs are held in place by muscles and other tissue. These muscles come together to create a support structure called your pelvic floor . Throughout your life, this support structure can start to weaken. This can happen for a variety of reasons, but the result is a sagging of your organs. When your organs sag or droop out of their normal position, this is called a prolapse. Vaginal prolapse is when the top of your vagina weakens and falls into your vaginal canal.
Prolapses can be small or large. A small prolapse is called an incomplete prolapse. A bigger prolapse (a complete prolapse) happens when your organ has shifted significantly. A complete prolapse can cause your organs to come out of your vaginal opening. This is a very severe prolapse.
Vaginal prolapse can cause painful symptoms. Mild to moderate vaginal prolapse may not require surgery. However, more severe cases may need surgical repair.
Your pelvis is comprised of your uterus, vagina, rectum, bladder and urethra. These organs are held up by your pelvic floor muscles, which look like an upside-down umbrella. The umbrella holds your pelvic organs up, but over time or due to other factors like vaginal deliveries, this upside-down umbrella can begin to collapse.
There are several different types of prolapse that have different names depending on where the organ has dropped from. The different types of pelvic organ prolapse can include:

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Vaginal prolapse is fairly common. More than one-third of women or people assigned female at birth (AFAB) have some type of pelvic area prolapse during their lifetime. You’re more likely to experience vaginal prolapse later in life, especially if you’ve had multiple pregnancies with a vaginal birth.
You may not know you have a prolapsed vagina until vaginal tissue from your vaginal wall protrudes from your vaginal opening. Some people have symptoms like pain or feeling like they are sitting on a ball. Others find out about a prolapsed vagina during a routine pelvic exam.
Several other pelvic organs can slip out of position, not just your vagina. Depending on the type of prolapse you have and its severity, other nearby organs may be affected. For example, you may have problems with your kidneys, urethra (the hole you pee from) and rectum (the hole you poop from). Because a prolapse can cause other problems, it’s important to get it checked out by your healthcare provider.
Symptoms of vaginal prolapse can include:
Some people don’t feel a prolapsed vagina because the prolapse is mild. Your healthcare provider may discover a mild prolapse during a routine gynecological exam. In other cases, you may feel like a ball is hanging from your vagina or experience pain when peeing or when having sexual intercourse.
Your vagina is held in place within your pelvis by a group of muscles and other tissue — creating a support structure, of sorts. This structure keeps your organs in your pelvis in place. Over time, this structure can weaken. When that happens, your vagina might slip down out of place, causing a prolapse. Several common causes of vaginal prolapse can include:
Activities or conditions that place extra pressure on your abdominal area can also cause a prolapse. These can include:
A gynecologist usually diagnoses vaginal prolapse during an appointment. They will do a physical exam and talk to you about any symptoms of fullness in your pelvic area or urinary incontinence (leaking pee). You may also be asked about any previous pregnancies and deliveries. In most cases, your provider can feel a prolapse by inserting a gloved finger in your vagina or upon a visual inspection of the area.
In some cases, you may not have any symptoms and your provider discovers a prolapse during a pelvic exam.
If you have problems peeing, your provider may order tests to check your bladder function. They may also order an MRI (magnetic resonance imaging) or pelvic ultrasound if they need a better view of all the other pelvic organs.
A prolapsed vagina is more likely to happen after menopause and after multiple vaginal childbirths. This is more likely to occur if you’re older than 50, but it can happen at any age.
Vaginal prolapse treatment can vary depending on the severity of your prolapse. In some cases, your healthcare provider may want to just watch it over time to make sure it doesn’t get worse.
There are nonsurgical and surgical treatment options for vaginal prolapses. There are a few things your healthcare provider will take into account when forming a treatment plan. These can include:
It’s important to have an open and honest conversation with your healthcare provider about these topics. Talk to your healthcare provider about any questions or concerns you have regarding these treatments.
Nonsurgical treatments are typically used as a first option and work best with minimal or mild prolapses. Specific treatment options can include:
For more severe cases, surgery to correct vaginal prolapse can be an option. These options include:
Not treating vaginal prolapse can cause the condition to worsen. In addition to more pain, you may also get sores on your vagina, infection and increase your risk for injury to other pelvic organs.
No, you can’t push a prolapsed vagina back up. Your healthcare provider is the only person who should treat a prolapsed vagina. You may be able to feel a prolapse, and you may need to push the prolapse back up to poop or pee, but pushing the prolapse back up is temporary and will not permanently fix the prolapse.
You can’t always prevent vaginal prolapse. There are good lifestyle habits you can adopt to decrease your risk of developing vaginal prolapse. These can include:
When you lift something heavy, you can strain your muscles. This strain can lead to a pelvic organ prolapse. By following a few tips, you can lower your risk of prolapse.
Vaginal prolapse can happen again after treatment. However, most treatment plans are very successful. If you have multiple prolapses or a severe prolapse, your healthcare provider may talk to you about surgical treatment options.
In most cases, the outlook for vaginal prolapse is positive. Treatment and lifestyle changes typically work well. Talk to your healthcare provider about all treatment options and what each option would mean for you. Your provider can help you develop good lifestyle habits that might help lower your risk of developing vaginal prolapse in the future.
Contact your healthcare provider if you have symptoms of prolapse like:
Don’t let symptoms of vaginal prolapse interfere with your daily life. See your healthcare provider if you have symptoms of vaginal prolapse like a bulging from your vagina or a feeling of fullness in your pelvis. Prolapse isn’t a serious condition, but it can cause problems if it’s left untreated or worsens. Mild cases of a prolapsed vagina can be fixed with Kegel exercises or a vaginal pessary. Surgery is needed in more severe cases.
Last reviewed by a Cleveland Clinic medical professional on 09/15/2022.

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Medically Reviewed by Traci C. Johnson, MD on September 24, 2022
Your uterus (or womb) is normally held in place inside your pelvis with various muscles, tissue, and ligaments. Because of pregnancy , childbirth or difficult labor and delivery , in some women these muscles weaken. Also, as a woman ages and with a natural loss of the hormone estrogen , their uterus can drop into the vaginal canal, causing the condition known as a prolapsed uterus.
Symptoms of a prolapsed uterus include:
Seek medical care immediately if you have any of the following:
Notify your doctor if you have any of the following symptoms:
Uterine prolapse happens when vaginal childbirth or other conditions weaken the muscles and tissues of the pelvic floor so they can no longer support the weight of the uterus. It can happen as a result of:
Your health care provider can diagnose uterine prolapse with a medical history and physical examination of the pelvis.
Treatment depends on how weak the supporting structures around your uterus have become.
You can strengthen your pelvic muscles by performing Kegel exercises. You do these by tightening your pelvic muscles, as if trying to stop the flow of urine. This exercise strengthens the pelvic diaphragm and provides some support. Have your health care provider instruct you on the proper ways to isolate and exercise the muscles.
Estrogen (a hormone) cream or suppository ovules or rings inserted into the vagina help in restoring the strength and vitality of tissues in the vagina. But estrogen is only for use in select postmenopausal women.
Depending on your age and whether you wish to become pregnant, surgery can repair the uterus or remove it. When indicated, and in severe cases, your uterus can be removed with a hysterectomy . During the surgery, the surgeon can also correct the sagging of the vaginal walls, urethra, bladder, or rectum. The surgery may be performed by an open abdominal procedure, through the vagina, or through small incisions in the abdomen or vagina with specialized instruments.
If you do not want surgery or are a poor candidate for surgery, you may decide to wear a supportive device, called a pessary, in your vaginal canal to support the falling uterus. You can use this temporarily or permanently. They come in various shapes and sizes and must be fitted to you. If your prolapse is severe, a pessary may not work. Also, pessaries can be irritating inside your vagina and may cause a foul-smelling discharge.
If you are not a good candidate for a hysterectomy or a pessary and are not going to have intercourse again, there is an option for a surgery called colpocleisis. During this procedure, the walls of the vagina are sewn shut.
Follow-up depends on how your condition was treated.
Pessaries can be effective temporarily or permanently if they are checked and cleaned as often as necessary. Surgery can support a prolapsed uterus or remove it.
Sarah Samreen, MBBS, Instructor, Department of Health Sciences, Ziauddin Medical University, Pakistan.
George Lazarou, MD, FACOG, Director, Urogynecology and Reconstructive Pelvic Surgery.
Jack D. Weiler, MD, Montefiore Medical Center and assistant professor, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine.
Aneela Naureen Hussain, MD, MBBS, assistant professor, Department of Family Practice, State University of New York Downstate Medical Center.
Suhaib Waqarul Haq, MBBS, Medical Officer, Department of Radiology, Abbasi Shaheed Hospital, Karachi, Pakistan.
Jeter (Jay) Pritchard Taylor III, MD, vice-chief/compliance officer Department of Emergency Medicine, Palmetto Richland Memorial Hospital, University of South Carolina.
Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine.
Lee P. Shulman, MD, professor of Obstetrics and Gynecology, head, Section of Reproductive Genetics, Feinberg School of Medicine, Northwestern University, Chicago.
Cleveland Clinic: “Cystocele (Fallen Bladder).”
John Hopkins Medicine: “Uterine prolapse.”
StatHealth : “Pelvic Prolapse Imaging.”
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Vaginal prolapse, also known as vaginal vault prolapse, occurs when the top of the vagina weakens and collapses into the vaginal canal. In more serious cases of vaginal prolapse, the top of the vagina may bulge outside the vaginal opening.
Symptoms of vaginal prolapse include the feeling of vaginal pressure or fullness — like you’re sitting on a small ball — and the sensation that something has fallen out of your vagina.
A cystocele or rectocele usually occurs with vaginal prolapse.
Mild cases of vaginal prolapse do not require treatment. Moderate to severe symptoms require nonsurgical therapies or minimally invasive surgeries, such as vaginal prolapse repair.

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Prolapse occurs when a woman’s pelvic floor muscles, tissues and ligaments weaken and stretch. This can result in organs dropping out of their normal position. Vaginal prolapse refers to when the top of the vagina — also called the vaginal vault — sags and falls into the vaginal canal. In severe cases, the vagina can protrude outside of the body.
There are no direct causes of vaginal prolapse. However, women are at an increased risk of developing vaginal prolapse if they:
Hysterectomy, a surgery to remove a woman’s uterus, is sometimes performed to treat uterine prolapse. However, vaginal prolapse can occur after hysterectomy (regardless of the reason for hysterectomy). This is called “vaginal prolapse after hysterectomy.”
Vaginal prolapse is relatively common. About one-third of women will experience some degree of prolapse during their lifetime. If you have more than one risk factor, your chances of developing vaginal prolapse increase.
Women with vaginal prolapse often report feeling pressure in the vaginal area, described as a throbbing pain in the vagina.
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