Surgical treatment of vaginal prolapse

Abstract

Introduction: Vaginal prolapse is characterized by a portion of the vaginal canal protruding from the opening of the vagina. The type of treatment depends on the cause and severity of the prolapse. Materials and methods: The study was based on 117 cases. Medical history, gynecological examination, bladder function test and pelvic floor strength, ultrasound, cystourethroscopy were performed. Results: Some types of vaginal prolapse were appreciated: cystocele in 28 cases (23,9%), rectocele in 12 cases (10,3%), uterine prolapse (75 cases - 64,1%) and vaginal vault prolapse after hysterectomy in 2 cases (1,7%). Factors that caused vaginal prolapse were: multiple births (80,4%), menopause (17,9%), hysterectomy (1,7%), advanced age in 47,9%. The following symptoms associated with vaginal prolapse were established: pressure in the vagina or pelvis (98 cases - 83,8%), pain that increases during long periods of standing (112 cases - 95,7%), enlarged vaginal opening (87 cases - 74,4%), difficulty of emptying bladder (48 cases - 41,0%), urinary stress incontinence (38 cases - 32,5%), constipation (17 cases - 14,5%), dyspareunia (72 cases - 61,5%). The symptoms affected sexual function in 79 cases (67,5%). Surgery was usually performed under spinal epidural anesthesia. Women's hospitalization required approximately 3-5 days. Patients were discharged from the hospital in a satisfactory condition. Long-term results were good. Many patients followed an estrogen replacement therapy, which helped strengthen and maintain muscles in the vagina. Conclusion: Surgery is the treatment of option for most sexually active women who develop a vaginal prolapse, due to the fact that the procedure is usually effective.