Pelvic relaxation is a weakening of the supportive muscles and ligaments of the pelvic floor. This condition, which affects women and is usually caused by childbirth, aging, and problems with support, causes the pelvic floor to sag and press into the wall of the vagina. About 9% of women require surgical repair for pelvic relaxation issues.
Common contributing factors to pelvic relaxation include childbirth (particularly vaginal delivery), obesity, aging, injury (eg, due to pelvic surgery), and chronic straining. Less common factors include congenital malformations, increased abdominal pressure (eg, due to ascites, abdominal tumors, or chronic respiratory disorders), sacral nerve disorders, and connective tissue disorders.
The general symptoms associated with pelvic relaxation depend on which organs are affected. Often there is a feeling of heaviness or fullness. Small or moderate amounts of urine may be lost with normal physical activities such as laughing, coughing, walking, or running (read about Stress Urinary Incontinence). 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:
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 felling of heaviness and fullness, or a sense that the uterus is falling out.
The diagnosis of these problems includes a through history and physical examination. Other tests, depending on the circumstances, include a "Q-tip" test, urodynamic studies (a painless fifteen to twenty minute computerized bladder and urethra functional studies), urethrocystoscopy (instrument used to evaluate the inside of the bladder and urethra), X-rays of the urinary system.
For all practical purposes, definitive treatment is surgical correction of the specific defects. Our cosmetic gynecologist, Dr. Troy Robbin Hailparn, is a Board-Certified OB-GYN with over 20 years of gyn surgery experience. She evaluates all vaginal rejuvenation patients for the above issues during the consultation. They can be corrected during surgery.
You can contact our office to schedule a consultation where all your questions and concerns will be addressed by Dr. Hailparn. Our number is 210-615-6646 or feel free to use our contact form.
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