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Vaginal
Relaxation and Functional GYN
Problems
Thirty
million American women suffer from symptoms of vaginal relaxation
and stress urinary incontinence.
Many
women have difficulty controlling their urine in certain situations
or notice changes in their bowel habits. These two symptoms may
be related to a common set of problems that may occur as a result
of childbirth, aging or a combination of both. Grouped together
these problems are referred to as pelvic relaxation.
Many
women suffer unnecessarily from conditions involving pelvic relaxation.
If you have any of these symptoms described in this section, contact
us at (248) 593-8780. Appropriate diagnosis and treatment will often restore patients
to a life free of the aggravations and discomforts associated with
pelvic relaxation.
The
goal is to acquaint you with the various forms of pelvic relaxation
as well as their causes, symptoms, and treatment. The pelvic organs
include the vagina, uterus, bladder, and rectum. These organs are
held in position by three types of supports: 1) muscles, 2) sheets
of tissue called fascia 3) and ligaments. When these supports become
damaged for various reasons, one or more of the pelvic organs may
sag and, occasionally, even protrude outside the vagina. These are
called pelvic support defects.
During
childbirth, as the baby passes through the birth canal, the muscles,
fascia, and ligaments separate and may be weakened. This weakening
gradually worsens and, in later years, may cause the pelvic organs
to drop from their normal positions.
Occasionally,
this weakening of the muscles and tissue may occur in women who
have never had children. In these women, the cause may be:
- Inherited
weakness of the supporting tissues
- Unusual
strain placed on the supporting tissues by a chronic cough
- Unusual
increases in abdominal pressure
- Obesity
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. 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:
- Cystocele
- Urethrocele
(most of the time the cystocele and urethrocele occur in combination
- cystourethrocele)
- Rectocele
- Enterocele
- Uterine
prolapse
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 test 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. |
