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Genital prolapse Causes, Symptoms and Treatment

Genital prolapse refers to the abnormal descent of one or more organs in the pelvic cavity. This phenomenon mainly affects women after 45 years and mainly affects the bladder, uterus, or rectum. Prolapse results from weakening or stretching the muscles and / or ligaments that support these organs. About 11 in every 100 women experience prolapse during their lifetime. The choice of treatment depends on the age, the severity of the disorder and possible complications. Prevention is based on reducing risk factors.

Description of genital prolapse

The organs in the pelvis (or pelvic cavity) are held in place by muscles, ligaments and fibers. And the pelvic floor, or perineum, supports them from below. Sometimes the muscles and ligaments weaken, distend and / or the pelvic floor , relaxes, causing more or less pronounced sliding of part or all of one of these organs (rectum, bladder , uterus) down. This is called prolapse.

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Types of genital prolapse

There are three types of prolapse:

  • The cystocele   or prolapse of the bladder: This is the most common prolapse which is 4 out of 5 cases (80% of cases). It is characterized by the fall of the bladder in the vagina.
  • Hysterocele or prolapse of the uterus: It is the descent of the uterus into the vagina caused by the collapse of the vaginal walls
  • The r ectocèle or rectal prolapse: This is the descent of the rectum into the vagina. Complete rectal prolapse corresponds to the total descent of the rectum into the anal canal.

Genital prolapse: population at risk and risk factors

Populations at risk

Prolapse occurs most often in women aged 45 to 85 years after menopause due to the loss of elasticity of the muscles and fibers that support the organs.

Risk factors for genital prolapse

  • Deliveries numerous and / or difficult
  • Age
  • Menopause
  • Overweight / Obesity
  • History of surgery in the basin region
  • Trades or physical exercises causing a great solicitation of the basin (wearing or pulling heavy loads, etc.)
  • Hereditary factor (family history)
  • Chronic constipation
  • In some athletes, excessive development of abdominal muscles

Symptoms of genital prolapse

Prolapse is mainly manifested by a feeling of heaviness in the pelvic cavity, a discomfort sometimes accompanied by pain.
Prolapse can also be manifested by the presence of a soft ball at the vulvar level, especially when standing or during an effort.

In case of cystocele, it is common that the woman has urinary disorders such as difficulty urinating, urination (urination) frequent or imperious, cystitis (inflammation of the bladder)

In case of rectocele, the evacuation of the stool can be difficult; the subject reaches sometimes to help his fingers. In some cases, the descent of the rectum gives rise to anal incontinence (involuntary loss of stool).

Sexual disorders can also manifest as a sensation of open bite of the vulva, a decrease in sexual sensations, pain or discomfort during penetration.

 

Diagnosis of genital prolapse

As a first step, the doctor asks the patient a few questions about the discomfort she feels and her background (circumstances of delivery, family history). Then, he makes a vaginal touch to estimate the descent of one or more organs. He may ask the patient to push coughing to better perceive prolapse. He examines the woman lying down, but also standing or squatting to better estimate the importance of prolapse.

Complementary examinations can be performed: urinary assessmentultrasound or MRI of the pelvic cavity and kidneys to identify possible renal damage.

If prolapse affects the rectum, rectoscopy (exploration of the rectum) and anorectal manometry (measurement of sphincter strength) will be considered.

Treatments for genital prolapse

Several factors must be taken into account before adopting the appropriate treatment: age of the person affected, menopause, severity of the disorder, associated complications, antecedents …

In some cases where the prolapse is of little importance, the therapeutic abstention can be advised by the doctor. He may also suggest the use of pessaries which is the only medical, non-surgical treatment of prolapse. It involves inserting into the vagina a device, often in the form of a ring, which helps to maintain organs that tend to descend.

Perineal rehabilitation helps to strengthen the pelvic cavity muscles , but it has a preventive or useful effect in the beginner prolapse.

If there is an obvious risk factor such as obesity, it must be treated. A proper hydration and proper diet (high fiber diet ) are recommended. The hormonal replacement therapies help fight against the tissue elasticity loss in postmenopausal women.

In the case of the most important prolapse, the doctor proposes a surgical procedure in order to fix the organ suffering from prolapse. There are several techniques depending on the type and degree of prolapse.

How to prevent genital prolapse?

The reduction of risk factors helps prevent prolapse  :

  • systematic pelvic floor rehab after pregnancy
  • attention to the perineum during childbirth,
  • treatment of obesity and constipation,
  • hormone replacement therapy during menopause,
  • protection of the muscles of the pelvic cavity during childbirth, …

This perineal reeducation is undoubtedly one of the effective methods to naturally improve the symptoms of beginner prolapse and prevent their degradation. Thanks to perineal rehabilitation, some surgeries can be avoided.

Moreover, if the surgical procedure has become necessary, perineal rehabilitation is still recommended to facilitate postoperative recovery.

Prescribed by a doctor and performed by a physiotherapist, this technique is the same as that which is routinely prescribed following childbirth to find a good bodybuilding requiring consolidation of the pelvic floor.

 

Complementary approaches to treat genital prolapse

Homeopathy

There are several homeopathic remedies available in case of prolapse, whether uterine or rectal.

Uterine prolapse:

  • Helonias dioica in 5 CH to calm the pains
  • But also Kalium bichromicum (if aggravated in hot weather).
  • We can also take Collinsonia canadensis or Calcarea phosphorica (a dose in 9 CH per week) in case of aggravation with the effort.

Rectal prolapse:

  • Podophyllum peltatum and if it follows a delivery we will take Ruta graveolens. We can also look to Hydrastis canadensis.

Phytotherapy

In herbal medicine, to fight against uterine prolapse, it is recommended to drink decoctions of white ash bark ( Fraxinus Americana ).

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