WOMENS-HEALTH Messages for March, 2000: Re: ?ing my doc's statement re prolapse

Re: ?ing my doc's statement re prolapse

From: D. Ashley Hill, MD (anonymous@obgyn.net)
Tue, 14 Mar 2000 19:29:06 -0600 (CST)

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At Tue, 14 Mar 2000, anonymous wrote: >
>Dear Docs
>When I went to my obgen, he informed me my uterus had dropped to almost
>a 2. He also said that this is quite common in women with children and
>that every time you deliver, your uterus drops further down.

The trauma of passing a baby through the vagina often damages the nerves surrounding the vagina and/or the muscles of the vagina and nearby organs, leading to "genital prolapse." However, while some women have tremendous prolapse after only one baby, others don't have any significant prolapse after 8 babies. Everyone is different. A fairly common problem after delivery is urinary incontinence, usually caused by the bladder "dropping" into the vagina (cystocele or paravaginal defect) from stretching due to childbirth. Also, some women report a rectocele, which is a hernia of the rectum into the bottom wall of the vagina. The majority of women who have this do not have any symptoms, but some report discomfort during intercourse, or the need to "splint" during bowel movements. This involves placing a finger or two into the vagina and pushing down in order to empty the rectum during a bowel movement. Again, this is uncommon, although not rare. This is one of the many things they don't teach in 8th grade health class about having babies!

C/section may help prevent this, but that is unproven. The pressure from the baby's head may damage the nerves, so c/section may not actually help (nobody knows for sure). Also, while some women have worsening symptoms after their next delivery, others report no change, even after many babies.

If prolapse becomes severe, some women request surgical repair. This might involve "tacking" the vagina, bladder, or uterus back into position, or vaginal hysterectomy. Other women decline surgery and opt for a pessary, which is a rubber "diaphragm" that the patient takes in and out of her vagina in order to push up the uterus and bladder during the day.

Hope this helps answer your question.

--
David Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
http://home.mpinet.net/dahmd

My apologies, but due to time constraints I am unable to answer private e-mails.

Next message: anonymous@obgyn.net: "Diane Re: active squamous epithelial cells"
Previous message: D.N.: "Syneral (sp?) Questions for doctors, please."
In reply to: anonymous: "?ing my doc's statement re prolapse"
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