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Wednesday, August 14, 2013

Does Your Vagina Have A Hernia?

Pelvic pressure is a common complaint, with many common causes. It can be a premenstrual cramp, a bit of bloating, a big meal or just what most pregnant moms feel. Pelvic pressure can be due to enlarging pelvic organs for reasons other than pregnancy: fibroids, or an ovarian cyst. Bladder infections, constipation, and hemorrhoids can also cause symptoms of pressure.  But there is something called a hernia due to a weakness in the very back upper portion of the vagina, called the pouch of Douglas, that can cause pelvic pressure. Some women have other pelvic problems at that same time as this internal vaginal hernia: they may have dropping of the bladder, the back wall of the vagina, or an actual dropping of the uterus itself. These problems, having the, cystocele, dropping of bladder, or a rectocele, dropping of the rectum into the vagina are actually both hernias as well, and an anatomic problem you may be able to have some sense of just by self examination. Internal hernias of the pouch of Douglas have to be diagnosed by examination, Symptoms women report can include delayed onset of urination, difficulty with bowel movements and even some vague vaginal itching. It should not cause bleeding, discharge or any actual acute pain. For some women the diagnosis is easy on pelvic exam, but for most, their gyno may be mystified as to the cause and need to order special studies like an MRI test or other imagining studies. There are surgical repairs that work, and in some cases pessary use can cure the problem as well. In fact small hernias are so common, may women would benefit by owning a pessary for those days of pounding: beach volleyball, square dancing, zumba, or cha cha cha classes. We can fit you for a pessary and advise on vaginal hernias at Women's Health Practice.

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