Gynecologist, Sex Therapist, Gynecology and Obstetrics Specialist Op.Dr.Esra Demir Yüzer gave information about the subject. The vagina is a flexible organ 8-10 cm long. The vagina differs personally in terms of width. However, the vagina is usually suitable for the entry of two fingers in a woman who has not given birth. While the vagina is structurally wide in some women, with advancing age, sagging, stretching and enlargement of the vagina may occur due to pregnancies and especially normal births. In addition, chronic bowel diseases (such as chronic constipation, ulcerative colitis), lung diseases such as asthma and COPD that cause chronic cough can also cause uterine and vaginal sagging. What complaints do women have when sagging, enlargement, and sagging of the vagina and uterus? Are vaginal and uterine prolapse the same disease?
The prolapse of the bladder on the anterior wall of the vagina towards the vagina is called a cystocele. The prolapse of the posterior upper wall of the vagina is called enterocele, and the prolapse of the posterior lower wall is called rectocele. There are 3 degrees of sagging of the vagina and uterus. Treatment varies according to the degree and type of sagging.
What complaints do women have about sagging, enlargement, and sagging of the vagina and uterus?
- There is a loss of pleasure in sexual intercourse in men and women.
- Air sounds come from the vagina during sexual intercourse.
- The woman says that she gets gas from the vagina while sitting up and getting up.
- While making his big toilet, he needs to press the area between the vagina and the anus, which we call the perineum.
- Stress urinary incontinence is the complaint of urinary incontinence when coughing and sneezing.
- He says that he feels as if something is going to come out in sagging and enlargement, which we call the third degree, as if he is sitting on a mass.
Are vaginal and uterine prolapse the same disease?
Although it is spoken as if the vagina and uterine prolapse are the same in daily speech, they are different things. Uterine prolapse is the prolapse of the uterus itself up to the vaginal entrance or even out of the vagina. Uterine and vaginal prolapse are often seen together.
What should be considered when deciding on vaginal and uterine prolapse surgeries?
- The type and degree of vaginal sagging should be determined exactly.
- In the surgery, the vagina should be repaired as a whole. 3-4 cm from the vaginal entrance. Until then, surgeries performed under office conditions are never sufficient and satisfactory surgeries.
- For the permanence of the surgery, besides the repair of muscle tears that cause vaginal sagging, suspending surgeries must be performed on the intact ligaments in the hip bone. If hanging surgeries are not performed, vaginal enlargement will recur in a very short time, such as 1-2 years.
- The materials used in the surgery should be of a quality that will ensure that they are permanent and robust.
- Vaginal and uterine prolapse surgeries must be performed under hospital conditions.
- Points to consider in uterine prolapse surgery:
- A definitive diagnosis should be made whether there is cervix lengthening with uterine prolapse. Sometimes, cervix elongation can look like uterine prolapse.
- For permanent treatment, suspending surgeries must be performed on the intact ligaments in the hip bone.
- In order for the woman to be aesthetically pleasing and feel psychologically better after the surgery, birth suture scars should be corrected as much as possible.
- If there is sagging asymmetry in the labia minora that impairs external genital aesthetics, the surgery we call labiaplasty can be performed simultaneously with vaginal surgery.
- What awaits women when vaginal and uterine prolapse surgeries are delayed?
- In severe prolapses, the cervix and the prolapsed part of the vagina protrude out of the vagina. Since the tissue in this area is not protected from external trauma, wounds called ulcers occur in the vagina and cervix that touch the underwear. Surgery cannot be performed without the treatment of ulcers.
- If the treatment of vaginal and uterine prolapses is left to advanced ages, surgery may not be performed due to systemic diseases such as high blood pressure and diabetes that occur with advanced age, because anesthesia and internal medicine doctors do not approve. In this case, it is tried to push the uterus into the vagina by using plastic rings, which we call pessary, so that the use of pessary and daily cleaning can be very difficult for women. Sexuality in marriage is important for the happiness of couples. If the vagina and uterine sagging are not corrected and the vagina cannot be permanently narrowed, there will be problems in marriages.