The pelvic organs include the vagina, uterus, bladder and rectum. These organs are held in position by three types of supports:
- Sheets of tissue called fascia
When these supports become damaged for various reasons, one or more of the pelvic organs may sag and, occasionally, even protrude outside the vagina. These are called pelvic support defects.
During childbirth, as the baby passes through the birth canal, the muscles, fascia and ligaments separate and may be weakened. This weakening gradually worsens and, in later years, may cause the pelvic organs to drop from their normal positions.
Occasionally, this weakening of the muscles and tissue may occur in women who have never had children. In these women, the cause may be:
- Inherited weakness of the supporting tissues
- Unusual strain placed on the supporting tissues by a chronic cough
- Unusual increases in abdominal pressure
There is often a feeling of heaviness or fullness. Small to moderate amounts of urine may be lost with normal physical activities such as laughing, coughing, walking or running.
In more advanced and rare cases, a mass may actually protrude from the vaginal opening. Based on the organ or organs involved, pelvic support defects can be defined more specifically as:
- Urethrocele (most of the time the cystocele and urethrocele occur in combination - cystourethrocele)
- Uterine prolapse
A cystocele occurs when the bladder falls or descends from its normal position. The most common symptom associated with cystocele is difficulty in completely emptying the bladder. This can be associated with bladder infections. Large cystoceles can cause the bladder to overfill and allow small amounts of urine to leak. Leakage is most common during activity such as walking or bouts of coughing.
A urethrocele usually occurs in conjunction with a cystocele. Both of these conditions result in, among other things, involuntary loss of urine, particularly when there is increased pressure in the abdomen, caused by walking, jumping, coughing, sneezing, laughing or sudden movements. Rectoceles happen when the rectum bulges into or out of the vagina.
Rectoceles usually occur as a result of injuries sustained during childbirth. With a weakened or bulging rectum, bowel movements become more difficult.
An enterocele is the bulging of small intestines into the back wall of the vagina.
Uterine prolapse occurs when the uterus falls or is displaced from its normal position. There are varying degrees of severity depending on the descent. This produces a general feeling of heaviness and fullness, or a sense that the uterus is falling out.
The diagnosis of these problems includes a thorough history and physical examination. Other tests depending on the circumstances include a "Q-tip" test, urodynamic studies (a painless 15- to 20-minute computerized study of bladder and urethra functions), urethrocystoscopy (in which an instrument is used to evaluate the inside of the bladder and urethra) and X-rays of the urinary system.
For all practical purposes, definitive treatment for vaginal relaxation and other GYN problems is surgical correction of the specific defects. Contact Rejuvenation Institute today to speak with a member of our staff in Ocean, Old Bridge or Brick, NJ.