Feeling something dragging down your vaginal canal can feel terrifying. It can restrict your activities and make you feel uncomfortable, particularly when you’re around other people or when you’re being intimate with your partner.

If you have this heavy feeling in your vagina, you should talk to your healthcare provider. The sooner the better.

What you are feeling is a possible prolapse organ such as your vagina.

Vaginal prolapse is a common condition that occurs after a vaginal hysterectomy and other conditions. Find out what it is and what you can do about it below.

What Is Vaginal Prolapse?

Vaginal vault prolapse happens when the upper part of the vagina loses its shape and starts dropping down into the vaginal canal. In severe cases, the organ drops down externally of the vagina.

The condition can happen alone or it can happen along with the prolapse of other pelvic organs such as the bladder, urethra, rectum, and small bowel.

The Signs and Symptoms of Vaginal Prolapse

Most women with vaginal prolapse report having the sensation of having something coming down. Others report it as a dragging sensation.

Apart from pelvic heaviness, you may also experience back pain. Incontinence or involuntary release of urine, vaginal bleeding, and having a mass protruding into the vaginal canal or the vagina can also happen.

Generally speaking, the more severe the prolapse is, the more severe the symptoms are.

The Risk Factors

While vaginal prolapse is common, there are certain factors that increase one’s risk of developing it. Below are some of its most common risk factors:

Childbirth

Giving birth to a baby, particularly a large baby, causes damage to the tissues, muscles, and ligaments around and inside the vagina. The same thing can happen with multiple births.

Menopause

After menopause, your estrogen level drops. This is the hormone that helps keep the muscles and tissues of the pelvic organs strong. With lower estrogen, the structures that support the pelvic area becomes weak and ineffective in doing their job.

Hysterectomy

Hysterectomy is the surgical procedure that removes the uterus. It’s performed  for different reasons, such as uterine fibroids, endometriosis, adenomyosis, abnormal vaginal bleeding, and cancer.

Without the uterus in place, the top part of the vagina may slowly fall toward its opening. And as it falls, it also puts stress on other ligaments and can pull the bladder and rectum along with it.

Apart from those factors, your risk of developing vaginal prolapse also increases if you have any of the following conditions:

• Abnormalities in your connective tissues
• Advanced age
• Previous pelvic surgery
• Obesity
• Strenuous physical activities
• Diagnosing Vaginal Prolapse
• Other Pelvic Organ Prolapse

A vaginal prolapse is basically diagnosed by performing a pelvic exam. During the assessment, your doctor will ask you to bear down as if you’re passing stool.

Apart from that, your doctor may also recommend a pelvic ultrasound, pelvic floor MRI, and CT scan of the abdomen and pelvic area to confirm the diagnosis.

Conservative Treatment Options for Vaginal Prolapse

If the condition is still mild, conservative treatment options might work. This includes pelvic floor exercises or Kegels.

The exercises are supposed to help strengthen the muscles that support the pelvic organs, including the vagina.

To do Kegels, you need to learn how to target your pelvic floor muscles first. You can do that by urinating and stopping your urine midstream. Start urinating again and then stop.

These steps can help you locate your pelvic muscles but you’re not supposed to use them to perform the exercise. Stopping your urine midstream several times can cause problems in the long run.

Once you are able to locate your pelvic floor muscles, you need to contract or squeeze them for a few seconds and then let go. Repeat the exercises about 8 to 10 sets, three times a day.

If you are overweight or obese, losing weight may help. Weight loss may help relieve some of the pressure off your pelvic organs. If you are unsure about how much weight to lose, you can ask your doctor.

Another conservative treatment option is a pessary. It’s a device made from rubber or plastic that’s inserted inside the vagina. It’s supposed to hold the bulging tissues and muscles in place.

For women who developed vaginal prolapse due to having low estrogen level, they may find estrogen replacement therapy helpful. However, if the condition is too severe, this option may not work.

Aside from that, there are also risks that come with hormone therapy. With that, you may want to be as thorough as possible in weighing the risks and benefits of the treatment option with your doctor.

Estrogen replacement therapy isn’t recommended for people with increased risk of stroke, blood clots, and certain types of cancer.

Another option is electrical stimulation. It involves the application of a probe to targeted muscles to measure and deliver minute electrical currents to stimulate contraction. The contractions are supposed to help strengthen the muscles in the affected area.

If those treatment options don’t work, your doctor may suggest surgery.

Repair of Vaginal Vault Prolapse

One of the most common and most effective approaches to treating vaginal prolapse and vaginal vault prolapse is surgery. With the procedure, the vagina is attached to the lower abdominal wall, the lumbar spine, or the pelvic ligaments. It can be done through an abdominal incision or through the vagina. Your surgeon can use either an artificial material (mesh) or your own tissues.  The surgery your doctor decides to perform depends on how healthy you are, age and activity level.

Here are the 5 types of surgery you can have to repair your prolapsed vagina:

Sacrospinous Ligament Fixation is performed by attaching the top part of your vagina to a ligament in your pelvic region known as the sacrospinous ligament.  Ligament is made of fibrous connective tissue and connects bone to bone and help stable them. This procedure is done through the vagina.

Abdominal Sacrocolpopexy is done via the abdomen. In this procedure, your surgeon will uses a mesh to create a bridge between prolapse vagina and your sacrum. This bridge works by suspending the vagina back it’s original position.

Uterosacral ligament Suspension is performed via the vagina or through small incisions in the stomach. This technique involves connecting the vagina to the uterosacral ligaments.

Iliococcygeus  Suspension/Fixation is performed via the vagina. In this procedure, your surgeon will suture the upper part off your vagina to the iliococcygeus muscle which happens to be one of the major muscles that is located in your pelvic floor.

Colpoclesis is not done often because it involves closing the top of the vagina. The front and back walls of the vagina is sewn together.

Prior to the surgery, a general anesthetic will be administered. With that, you may be required to stay in the hospital for a day or two.

Like other surgeries, the surgical repair of vaginal prolapse still has possible complications but they are uncommon. The list includes:

• Urinary incontinence
• Formation of a fistula or an abnormal opening between organs
• Bleeding
• Mild pain in the buttocks for about 1 to 2 months after surgery
• Urinary retention

After surgery, you’ll be advised not to engage in any strenuous activity within 6 weeks. You should gradually increase your activity to facilitate proper healing.

For most women, sexual intercourse is possible after 6 weeks. In general, you can expect to be able to return to your previous level of activity after 3 months. To get a better idea of your progress, schedule follow-up visits with your doctor.

Summary

If diagnosed early your prolapsed vagina can be fixed without surgery so don’t wait till it’s too late.

If you have any surgery in your pelvic region,  talk to your doctor about exercises that you can do to keep your pelvic floor muscles strong.