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DESCRIPTION
A vaginal hernia is a weakness in the pelvic supporting structure that allows the pelvic organs to descend into the vagina.
- Cystocele - is a descent of a portion of the bladder into the vagina.
- Enterocele - is a protrusion of the intestine through the back of the vaginal wall.
- Rectocele - is a protrusion of the rectum through the vaginal wall.
- Urethrocele - is a sagging of the urethra. When associated with a cystocele, it is called a cystourethrocele.
MoonDragon's Obgyn Information: Uterine Prolapse - Helpful information about uterine prolapse, vaginal vault as well as other types of prolapses/hernias discussed here.
FREQUENT SIGNS & SYMPTOMS
Sometimes, no symptoms are apparent.
Stress incontinence (urine leakage that occurs with coughing, sneezing or lifting.
Incomplete emptying of the bladder.
Increased urinary frequency.
Urinary incontinence.
A sensation of vaginal fullness, pressure or "falling out".
Pain during sexual intercourse.
Increased susceptibility to urinary tract infection (UTI).
Constipation caused by a rectocele that interferes with muscle contraction in the rectum.
CAUSE
Weakness in the tissues of the vaginal wall.
RISK INCREASES WITH
Multiple pregnancies.
Congenital malformations.
Prolonged labors.
Birth of a large baby.
Lack of estrogen in menopause .
Obesity.
Chronic cough, such as in chronic bronchitis. Fenake smokers are at higher risk of developing a vaginal hernia.
Constipation.
Occupations involving much standing and lifting, such as working in the nursing profession.
Large pelvic tumors.
PREVENTIVE MEASURES
Pelvic strengthening exercises (Kegel exercises) during and following pregnancy. Kegels should be done every day to be effective.
Estrogen therapy (hormone replacement therapy) after menopause.
Avoidance or correction of obesity, chronic cough, straining and traumatic deliveries (which includes episiotomy, forceps and vacuum extractions).
Plenty of daily fiber and fluids to prevent constipation.
EXPECTED OUTCOME
With small or moderate sized hernias, conservative therapy is usually sufficient to relieve symptoms.
In more severe cases, surgery is curative.
POSSIBLE COMPLICATIONS
Recurrent urinary tract infections (UTIs).
Uterine prolapse.
Chronic constipation. Fecal impaction.
TREATMENT
GENERAL MEASURES
Diagnostic tests may include examination of vagina and pelvis, pelvic xray, urinalysis, cystoscopy and urethroscopy (both use a telescopic instrument with fiberoptic light for diagnosis.
Treatment measures will depend on the severity of the symptoms, age of the woman and desire for future pregnancies. Treatment steps may include exercises, use of a pessary, medications and surgery.
Other treatment steps may be recommended for obese patients, those with chronic cough or chronic constipation.
Kegel exercises will help to tighten and strengthen the pelvic floor muscles and relieve symptoms.
Use of a pessary (a device placed in the vagina to help support the uterus) may provide adequate temporary support. See Uterine Prolapse for information about pessaries and how they are used.
Surgery is recommended for severe symptoms and is usually required for final resolution. There are different methods depending on the type of defect, any associated conditions, desire for future pregnancies, and age and general health of the woman.
Rarely, an enterocele may require emergency procedures.
MEDICATION
Antibiotics if infection is present.
In postmenopausal women, estrogen or hormone replacement therapy may improve the tone and quality of the pelvic support muscles.
Pain medication if required following surgery.
Stool-softening laxatives and lubricating rectal suppositories may be necessary for constipation caused by rectocele.
ACTIVITY
Avoid occupations or activities that require heavy lifting or cause intra-abdominal pressure.
DIET
If overweight, a weight loss diet is recommended and behavior modification techniques for weight control should be examined.
Eating a high fiber diet and increasing fluid intake help relieve problems of constipation.
NUTRITIONAL RECOMMENDATIONS
Nutrients Supplement Suggested Dosage Comments Essential Calcium 1,500-2,000 mg daily. Essential minerals needed for muscle tone and metabolism. Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz., Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 Gelcaps, Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz. And
Magnesium750-1,000 mg daily. Important in Calcium uptake. Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz., Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 Gelcaps, Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz. Bone Defense from KAL As directed on label. A good source of necessary minerals and other nutrients. Bone Strength, NOW Foods, 240 Caps, Calcium Complex Bone Formula, Nature's Way, 100 Caps, Bone, Flesh & Cartilage, Nature's Way, 100 Caps L-Carnitine 500 mg twice daily, on an empty stomach. Improves muscle strength in the uterus. L-Carnitine (Acetyl), NOW Foods, Pharmaceutical Grade, 500 mg, 100 Caps And
L-glycine500 mg twice daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg vitamin C for better absorption. Retards muscle degeneration. L-Glycine Powder, Free Form, Vegetarian, 1 lb. Plus
branched chain amino acid complexAs directed on label. Promotes healing of muscle tissue. Branched Chain Amino Acids, Free Form, 120 Caps, Branched Chain Amino Acid Powder, NOW Foods, 12 oz. Zinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Important for calcium uptake, bone support, all bodily enzyme systems, and immune function. Use zinc gluconate lozenges or OptiZinc for best absorption. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps, Ionic Zinc, 50 mg, 2 fl. oz., Trace Minerals Multivitamin and mineral complex
with
natural beta-carotene
and
vitamin B complexAs directed on label. All nutrients work together for healing and tissue repair. Alive! Whole Food Energizer Multi-Vitamin & Mineral with Naturally Occurring Iron (No Iron Added), Nature's Way, 180 Tabs Vitamin C 3,000-5,000 mg daily, in divided doses. Important for keeping bladder infections under control and to enhance immune function. Use an esterified from for best absorption. Vitamin C Liquid, with Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, 1,000 mg, 16 fl. oz., Dynamic Health, Vitamin C 1000 w/Bioflavonoids, Nature's Way, 100% Natural, 1,000 mg, 250 Vcaps
Vitamin C 1000 w/ Bioflavonoids, Nature's Way, 100% Natural, 1,000 mg, 250 Vcaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.
Just An Ounce, Calcium and Magnesium Liquid can help with the development of strong bones and teeth, also prevents muscle cramping, risk of colon cancer, maintain regular heart beat, protects against osteoporosis and helps relax the central nervous system.L-Carnitine, Stable Tartrate Form, NOW Foods, 250 mg, 30 Caps
Pure L-Carnitine is an amino acid that normally attracts water which can cause it to deteriorate rapidly. We use a tartrate form to help ensure that NOW L-Carnitine maintains stability and full potency.Alive! Whole Food Energizer Multi-Vitamin & Mineral, w/ Naturally Occurring Iron (No Iron Added), Nature's Way, 90 Vcaps
No other supplement contains more life-giving nutrients than ALIVE! It is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands.Zinc Lozenges w/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges
Nature's Way Zinc lozenge boosts cold season defense with zinc, widely recognized as an important nutritional support during the cold season, and echinacea pupurea, clinically shown to support the immune system, and Vitamin C, a vitally important vitamin for general health maintenance.Buchu, Urinary / Kidney Herb, 2 fl. oz., African Red Tea Imports
Buchu, the urinary herb, has traditionally been claimed to treat a wide variety of disorders. Buchu is commonly used as a natural diuretic, thus assisting with relieving premenstrual bloating.Cranberry Extract STD w/ Ester C, Nature's Way, 400 mg, 120 Tabs
Cranberry Extract with Ester is primarily useful for female adults and those with chronic or recurrent urinary tract infection. used to prevent urinary tract infection and relieve cramps and spasms. It also helps maintain a healthy urinary tract by inhibiting the adhesion of E. coli bacteria to the lining of the bladder.Damiana Tincture, 100% Organic, 2 fl. oz.
Damiana is used to treat asthma and other respiratory diseases, depression, digestive problems, menstrual disorders, and various forms of sexual dysfunction such as impotence in men, and inability to achieve orgasm in women.Ginger Root, Nature's Way, 550 mg, 180 Caps
Ginger root is especially useful for bowel disorders including indigestion, morning sickness, motion sickness and nausea.
Mountain Rose Bulk Herbs
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Mountain Rose Herbs, Aromatherapy Oils C-E
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Mountain Rose Herbs, Aromatherapy Oils: Oil Kits
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NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has symptoms of a vaginal hernia.
Symptoms don't improve or they worsen despite treatment.
Signs of infection develop (fever, chills, aches).
