Herniated vagina

Definition

A vaginal prolapse is a protrusion of the vagina from the entrance to the vagina. If the vagina goes deeper without a protrusion, this is known as vaginal prolapse (Descensus vaginae). In addition to the descent of the vagina, the uterus can also descend, which can also fall out through the vagina. These clinical pictures often occur together. The trigger is a weakness of the pelvic floor or an increase in pressure in the abdominal cavity and occurs more frequently with increasing age.

Causes

A vaginal prolapse usually affects women who have already given birth. This can lead to damage to the holding apparatus of the vagina and to nerve damage. In addition, a weakness of the pelvic floor, either congenital or a consequence of menopause, can promote a prolapse of the vagina with resulting prolapse.

Long-term incorrect or excessive strain on the pelvis can also be accompanied by weakness of the muscles and ligaments present there. A further cause of a vaginal prolapse is increased pressure in the abdominal cavity. This pressure is caused by obesity, chronic coughing or constipation, for example.

Birth is a common cause of a vaginal prolapse. Especially traumatic births, which lead to massive overstretching and injury of pelvic structures, can cause pelvic floor weakness. Due to this weakness, the genital organs can sink and fall through the vagina to the outside.

The uterus or vagina can be affected. After a vaginal birth, irritation of nerves can also cause the genital organs to sink temporarily, which will disappear of its own accord as the nerves recover. Risks include multiple births, a long expulsion phase and mechanical birth complications.

An episiotomy can prevent the risk of subsidence by relieving pressure and reducing the probability of tearing. After removal of the uterus (hysterectomy), there may be a lowering or prolapse of the vagina. The uterus is anchored in the pelvis by various support structures. Since the vagina is connected to the uterus, these support each other. If the uterus and its attachments are now removed, the vagina may lose its hold and descend.