There is a fleshy ball at the vaginal opening after normal delivery

After a normal delivery, there is a fleshy ball at the vaginal opening, which may be the cervix. The upper part of the vagina may be normal vaginal wall tissue. You can go to the hospital and ask the doctor to check whether there is a problem of uterine prolapse and vaginal wall bulging. Cystocele is a very common bulge in the anterior vaginal wall. It is actually a protrusion of the bladder and urethra that often causes confusion in urination. Mild protrusion is more common in multiparous women and generally there are no symptoms.

disease

1. Symptoms

In mild cases, there may be no symptoms; in severe cases, there may be a feeling of falling downwards and lower back pain, which is aggravated after standing for a long time. Something comes out of the vagina automatically. It expands when the abdominal pressure increases during labor or when urine accumulates in the bladder. It shrinks or even disappears after resting in bed or urinating. There is a feeling of fullness in the vagina, as well as a feeling of being compressed or "falling down". There is also a feeling of incessant urination, and one needs to pull up the protruding vagina to urinate completely. In severe cases, urination may be difficult and there may be residual urine, which is prone to cystitis, resulting in frequent urination, urgency and pain when urinating. If the bladder is moderately or severely relaxed, the angle of the bladder urethral opening is reduced, and the urethral sphincter is relaxed and incompletely closed, urine may overflow when coughing, straining, etc. increase abdominal pressure. This is called stress urinary incontinence.

2. Clinical symptoms

The patient is first examined in the lithotomy position. If no corresponding clinical symptoms are found or the extent of the prolapse cannot be confirmed, the standing position examination should be performed. Check the reproductive organs and check when the bladder is full. The protrusions on the anterior vaginal wall or the internal and external vaginal openings are soft and can be retracted. When abdominal pressure is increased or coughing occurs, the protrusions expand, accompanied by the contraction of the anterior vaginal wall and urethral opening. If the urethral opening is complicated by protrusion, the urethral opening will move downward and forward in a rotating manner when abdominal pressure is increased. If no significant slipped tissue is found, the labia minora are gently separated to expose the vestibule and rupture the hymen. The consistency of the perineal body was assessed and the size of the slipped tissue was estimated. The posterior leaf of the speculum is pressed against the posterior wall of the vagina, which helps to expose the anterior wall of the vagina. Then ask the patient to hold his breath or cough hard to observe the slippage of the pelvic organs, which is helpful to distinguish between outer wall damage and central damage. The former is manifested as the disappearance or separation of the medial vaginal groove. The protrusion of the center line is mainly manifested by the existence of the medial vaginal groove. Lowering of the anterior vaginal wall can result in lowering of the bladder, with or without excessive movement of the urethral opening.

3. Clinical medical measurement range

Grade I (mild): The bulging of the anterior vaginal wall has reached the edge of the hymen but has not protruded from the vaginal opening.

Grade II (mild to moderate): Part of the anterior vaginal wall bulges out of the vaginal opening.

Grade III (moderate to severe): The anterior vaginal wall protrudes beyond the vaginal opening.