When prolapse is used in the medical field, it refers to organs falling down or slipping out of place. The term prolapse is used for organs that are protruding through the rectum, vagina or valves in the heart that are aligned incorrectly. Sometimes a disc herniation in the spine is referred to as a disc prolapse; this however is outside the scope of prolapse considered on this website.
The three key forms of prolapse are discussed below.
I. MITRAL VALVE PROLAPSE (MVP)
This is a heart disease. A thickened mitral valve leaflet that is displaced into the heart’s left atrium during its systole phase characterizes this condition.
Symptoms of MVP
- Anxiety/panic attacks
- Chest pain
- Although rare, stroke is also a complication related to MVP
Treatment for MVP
- Mitral valve prolapse surgery – to repair or replace valves
Learn more about mitral valve prolapse here.
II. PELVIC ORGAN PROLAPSE (POP) (also Female Genital Prolapse)
This condition relates to the pelvic organs extending into the vagina. Organs such as the bladder (cystocele / bladder prolapse), uterus (uterine prolapse), small bowel (enterocele), rectum (rectocele), and upper portion of the vagina (vaginal vault prolapse) fall into the vaginal canal.
Symptoms of POP
- Pulling in groin
- Painful intercourse
- Urgency and frequent urination (especially during the night)
- Pelvic pressure or the feeling that something is falling from the vagina
- Bleeding/spotting from the vagina
- Difficulty with bowel movements
Causes of female genital prolapse
- Respiratory problems that include a chronic cough
- Pelvic organ cancers
Treatments for POP
- Kegel exercises
- Vaginal pessary – a plastic device is used to support the pelvic floor, which in turn supports the falling organ(s)
- Pelvic organ prolapse surgery – reconstructive or obliterative
Learn more about pelvic organ prolapse here.
III. RECTAL PROLAPSE
This condition involves a portion of, or the entire wall of the rectum falling out of place. There are cases where the rectum exits the body. This is referred to as protrusion.
The three kinds of rectal prolapse
1. Complete prolapse
The wall of the rectum falls and sticks out of the body. This condition may occur during a bowel movement, while standing or walking. While rare, the tissue may remain outside of the body at all times.
2. Partial prolapse
The rectum’s lining falls out of place. This happens while straining to make a bowel movement. This condition is sometimes confused with internal hemorrhoids.
Both complete and partial prolapses can usually be pushed back inside the body. When this is done, the prolapse is referred to as being reduced.
3. Internal prolapse (Intussusception)
This condition is characterized by the sliding of one large intestine (colon) wall into or over another part of the colon. This condition occurs internally, so the tissue remains inside the body.
Rectal prolapse causes
There are numerous causes for the occurrence of rectal prolapse, including:
- Weakening of the tendons supporting the rectum
- Persistent straining to make a bowel movement
- A weakened anal sphincter muscle
- Stress related to childbirth
- Neurological issues (spinal cord disease or spinal cord transaction)
- Genetic predisposition
Symptoms of rectal prolapse
- Tissue protruding from the rectum
- Leaking stool
- Anal pain
- Bleeding from the anus
Other symptoms include:
- Feeling as if the bowels are unable to be emptied completely
- Passing numerous tiny stools
- Feeling as if the bowels are full and urgency to have a bowel movement
Treatment for rectal prolapse
The goal is to avoid constipation to limit straining during bowel movements.
- Diet – a diet that is rich in fiber, including six to eight glasses of decaffeinated beverages every day will help keep stools softened.
- Physical Therapy and Biofeedback – sometimes these therapies can help avoid straining and strengthen weak anal sphincter muscles and ligaments.
- Kegel exercises – if the anal sphincter muscles are weakened, performing Kegels may strengthen them.
- Rectal prolapse surgery – there are two kinds of surgery used to treat a complete rectal prolapse:
- A surgeon can operate through the area located between the anus and the genitals. In this surgical procedure, he removes the prolapsing tissue.
- He may choose to operate via the stomach to a secure portion of the rectum or large intestine located inside the abdominal cavity.
A surgeon may decide to remove the portion of the colon that is affected. Generally, surgical intervention is successful for those who still maintain some kind of control over their bowel.
Learn more about rectal prolapse here.