A relaxed vaginal outlet

Submitted by sybille on June 10, 2005 - 1:23pm
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Excerpt from Relaxed Vaginal Outlet

Synonyms, Key Words, and Related Terms: relaxed perineum, perineoplasty, vaginal prolapse, pelvic prolapse, uterine prolapse, urethral hypermobility, cystocele, rectocele, enterocele, perineal relaxation, pelvic floor relaxation

Please click here to view the full topic text: Relaxed Vaginal Outlet
The current generation of women is maintaining a more active lifestyle into an older age, resulting in an increase in the number of women who seek treatment for prolapse conditions. Consequently, an increased need for expertise in the diagnosis and treatment of these conditions is likely. An active lifestyle and improved quality of life can usually be preserved; however, this requires a thorough understanding of pelvic anatomy and pathophysiology and experience in selecting appropriate surgical procedures.
Problem: A relaxed vaginal outlet can be defined as the relaxation of the tissues of the distal rectovaginal septum and perineal body. Common symptoms include difficulty with defecation and, possibly, sexual dysfunction.

Frequency: In the United States, the exact incidence of relaxed vaginal outlet is unknown because not all patients are symptomatic; however, it is thought to be quite common.

Etiology: The main support for the pelvic viscera is provided by a group of muscles collectively called the levator ani. An intact pelvic floor allows the pelvic and abdominal viscera to "rest" on the levator ani, significantly reducing the tension on the supporting fascia and ligaments. These pelvic ligaments are not true ligaments and are simply condensations of endopelvic fascia covering the pelvic structures.

The pelvic floor musculature and the pelvic ligaments work together to provide support to the pelvic floor structures. Most of the weight of the pelvic viscera is supported by the levator ani, whereas the pelvic ligaments stabilize these structures in position, much as a ship

Christine

June 11, 2005 - 10:11am

Hi Sybille,

This is precisely the conceptual framework I take issue with regarding the pelvic

mel

June 11, 2005 - 7:18pm

this information is all very new to me. i recently had a pelvic and abdominal ultrasound and this is where i learned where most of these organs even are. sad how little i knew about my body even after 2 kids! i am wondering if it the colon above the perineum. i have been feeling that my perrineum is pushing down. i can actually feel it on the outside that this area is 'tense'. when i lay down it remains tense for a while and then lets up after about an hour of relaxation. is this the feeling of the rectocele? i'm just wondering what else could possibly be pushing down on that area. i remain fully consious of the posture all day, i really feel that my uteris is staying in a better position but the cystocele and rectocele (supposedly grade 2 & 1) are seemingly not as cooperative. i am pretty far in the book and so much of it is inspiring to me. i came from a family of health consious eaters and thankfully have a good whole food background but the reading just reconfirms and reminds me to stay aware of what we consume. i am just totally amazed that you (christine) whore a pessary for 7 years (think i got that right?) and now can go without?!?!? i know that this is your work so of course you are thinking of it everyday but do you go for days or a day without thinking about having an uncomfortable vagina? i really wonder that.
wow, this info again is truly inspiring. thanks and good night from a very hot humid town in ontario!!! mel

sybille

June 11, 2005 - 7:33pm

That is why we need you, Christine - to straighten out thinking erros in the medical community.

Sybille

Christine

June 11, 2005 - 8:35pm

Dear Mel,

I referred to my seven years pessary experience in the book, but that was not constantly for seven years by any means, and I wore it for entirely too long, I am certain. I remember at times running to the bathroom to take it out as the dull ache of my cervix being decapitated by the silicone rim grew in sudden intensity.

Mel, I still have prolapse. The wonder is that my uterus drew up significantly (still significantly prolapsed

mel

June 12, 2005 - 8:23am

thanks christine, just trying to get it all straight. mel

BaNa48

July 2, 2005 - 12:27pm

Christine and all ladies, In your expert opinion for rectocele, entorocele and cystocele is there any way that you could add some pictures? Maybe cartoon style, not graphic, from side angle and front? I don't understand everything about the woman's anatomy and this would help some of us! I am going to another gyno next week (woman) and I want to be as much informed as possible. I am copying some of your notes word for word and I plan on using them in our conversation there! Also I need to know for myself what works best for me. I am starting the veggies and fruit diet this week because I am always using prune juice for constipation! This must be heritary, because my Mom is the same. My sister doesn't have this problem and is plagued with irritable bowel most of the time. Also, the Mayan exercises, anyone out there, I have another question! Starting at the pubic bone and moving your fingers upward, when I get close to the naval area, the pressure hurts! What does this mean? Am I doing something wrong? I feel bad for the ones that are in pain, as I don't have this problem! One more question, when feeling up there, what is that thing with an inverted dimple? Uterus??? I am embarassed to let you all know how dumb I am about my anatomy, but I had never been to a gyno before this problem. Always my family doctor and you know how much they tell you! Always go see the surgeon is their answer for most things. I am doing fairly well right now and I hope all of you are too. Thanks for listening and I'm glad nobody can see my face because I am embarassed but want to know!!!!!!!! Thanks, Nancy

mel

July 2, 2005 - 6:39pm

i am pretty sure that you are feeling the cervix. which will not always be the same depending on your cycle. i can't believe that opens up enough for a baby to pass through. crazy. i only recently learned about where these parts were from a recent ultrasound. i went with a full bladder and then i was told to emplty it. apparently i did not completely empty, which happens with a cyctosele, because she could see retained urine. i tries to empty the rest with no sucess. this made me see the importance of tilting the pelvis while urinating or going on all fours once a day to get rid of any stale urine. we are all learning everyday! think of yourself as one step ahead, afterall, you are here, learning and sharing! take care, mel

BaNa48

July 2, 2005 - 7:09pm

Mel, Thank you! Now I'm a little smarter anyway. Nancy

Christine

July 3, 2005 - 7:35am

Dear Nancy,

Yes, we will have much better anatomical drawings with the new website. I