VAGINAL PROLAPSE

Anterior wall

Cystocele — The cystocele is formed by laxity and descent of the upper two-thirds of the anterior vaginal wall. As the bladder base is closely related to this area, there is herniation of the bladder through the lax anterior wall.

Urethrocele — When there is laxity of the lower-third of the anterior vaginal wall, the urethra herniates through it. This may appear independently or usually along with cystocele and is called cystourethrocele.

Posterior wall

Relaxed perineum—Torn perineal body produces gaping introitus with bulge of the lower part of the posterior vaginal wall.

Rectocele— There is laxity of the middle-third of the posterior vaginal wall and the adjacent rectovaginal septum. As a result, there is herniation of the rectum through the lax area.

VAULT PROLAPSE: -

Enterocele — Laxity of the upper-third of the posterior vaginal wall results in herniation of the pouch of Douglas. It may contain omentum or even loop of small bowel and hence, called enterocele.

Traction enterocele is secondary to uterovaginal prolapse. Pulsion enterocele is secondary to chronically raised intra-abdominal pressure.

Secondary vault prolapse — This may occur following either vaginal or abdominal hysterectomy. Undetected enterocele during initial operation or inadequate primary repair usually results in secondary vault prolapse.

HOMOEOPATHIC MANAGEMENT OF VAGINAL PROLAPSE

Sepia:- This medicine is indicated when there is constant bearing down sensation as if the genitals are dragged in downward direction. Crossing the lower limbs may prove slightly helpful to decrease the bearing down sensation. Prolapse at Menopause may be accompanied by hot flushes with excessive sweating.

Lilium tigrinum:- Beneficial in women suffering from prolapse. There is constant urge to pass urine or stool. This is most of the times accompanied by a distended feeling in the pelvis. Supporting the vulva or taking rest brings about a slight relief in the dragging sensation.

Murex:- Women experience a bearing down sensation in the Pelvis and need to tightly cross legs to prevent the bearing down sensation. Murex also proves useful in decreasing the pain during periods due to a prolapsed and displaced genitals.

Lappa Arcticuma:- Used in all cases where the muscles, ligaments and tissues in pelvis lack tonicity and are relaxed to a greater extent, resulting in a displaced or prolapsed womb.