Genital Prolapse

Genital prolapse, also known as pelvic organ prolapse (POP), occurs when the muscles and tissues that support the pelvic organs (such as the uterus, bladder, and rectum) weaken or stretch, leading to the descent of these organs into the vaginal canal. This condition is more common in women, especially those who have experienced childbirth, hormonal changes during menopause, or other factors that contribute to weakening pelvic floor muscles.

1. Genital Prolapse Presented by: Dr.Saima Mustafa(pt)

2. Objective: Defination of genital prolapse Causes of genital prolapse Symptoms of prolapse Diagnosis Treatment

3. Prolapse of the uterus or vagina is usually the result of loss of pelvic support, and causes mainly non-specific symptoms. It may affect over half of women aged 50 to 59 years , but spontaneous regression may occur. Risks of genital prolapse increase with advancing parity and age, increasing weight of the largest baby delivered, and hysterectomy. Anterior vaginal wall prolapse : when the bladder and/or urethra bulges into the front wall of the vagina.

4. Causes: Uterine prolapse occurs from weakened or damaged muscles and connective tissues such as ligaments allow the uterus to drop into the vagina Common causes include: Pregnancy Childbirth Hormonal changes after menopause Obesity Severe coughing Straining on the toilet

5. Symptoms: Seeing or feeling tissue bulge out of the vagina. Feeling heaviness or pulling in the pelvis. Feeling like the bladder doesn't empty all the way when you use the bathroom. Problems with leaking urine, also called incontinence

6. Urinary Symptoms: Stress urinary incontinence: Leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, or exercising. Urinary urgency: A strong, sudden urge to urinate that may be difficult to control. Incomplete emptying: Difficulty fully emptying the bladder, resulting in frequent urination or the need to strain to urinate.

7. Bowel Symptoms: Constipation: Difficulty passing stools or incomplete bowel movements. Straining: Needing to push or strain during bowel movements. Incomplete emptying: Feeling like the bowels are not completely empty after a bowel movement. Fecal incontinence: Accidental leakage of stool or difficulty controlling bowel movements.

8. Sexual Symptoms: Vaginal discomfort or pain during sexual intercourse. Decreased sexual satisfaction due to changes in vaginal sensation. Emotional distress and reduced sexual desire.

9. Local Symptoms: Vaginal bulge or protrusion: A visible or palpable lump or pressure sensation in the vaginal canal. Pelvic pressure or heaviness: Feeling as though something is falling out or bearing down in the pelvic region. Vaginal discharge or irritation: Discomfort or abnormal discharge related to the prolapsed organs' presence.

10. Types of genital prolapse: Cystocele—The bladder drops into the vagina Enterocele—The small intestine bulges into the vagina Rectocele—The rectum bulges into the vagina Urethrocele: Your urethra bulges into your vagina

11. Grading systems: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635656/

12. Diagnosis: Dynamic pelvic MRI scan Ultrasound

13. Treatment: A prolapse may be treated effectively using a vaginal pessary . Surgery may also be an option for some women: Anterior repair Posterior repair Vaginal hysterectomy