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Pelvic floor dysfunction can result after treatment for gynecological cancers. [9] Damage to the pelvic floor not only contributes to urinary incontinence but can lead to pelvic organ prolapse. Pelvic organ prolapse occurs in women when pelvic organs (e.g. the vagina, bladder, rectum, or uterus) protrude into or outside of the vagina.
A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. [2] However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed section is visible externally, and whether the full or only partial thickness of the rectal wall is involved.
Pelvic organ prolapse (POP) is characterized by descent of pelvic organs from their normal positions into the vagina. In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. [ 2 ]
This pelvic floor muscle is normally supposed to relax, thereby straightening the anorectal angle and allowing rectal contents to be evacuated. Dyssynergic defecation causes high pressure in the rectum and in the anal canal, [ 1 ] which causes lengthening [ 1 ] and compression of the rectal tissues, which in turn leads to ischema of the mucosa ...
The rectum or urinary bladder may prolapse as a result of changes in the integrity of connective tissue in the posterior or anterior vaginal walls, respectively, resulting in pelvic floor prolapse. Symptoms may include a feeling of pressure in the pelvis, or the visible protrusion of organs from the vagina.
Mechanistically, the causes of pelvic floor dysfunction are two-fold: widening of the pelvic floor hiatus and descent of pelvic floor below the pubococcygeal line, with specific organ prolapse, graded relative to the hiatus. [10] People with an inherited deficiency in their collagen type may be more likely to develop pelvic floor dysfunction.
Sigmoidocele is a prolapse of peritoneum that contains a section of sigmoid colon. In females, these prolapses usually descend between the rectum and the vagina. They are most likely to be seen during straining. Rectal prolapse/Internal rectal intussusception: The rectum may be seen to prolapse, whether internally or externally.
Abnormalities in the rectal wall occur with descent of the pelvic floor and pelvic organ prolapse. With increasing descent, the rectum assumes one of 3 possible configurations: internal rectal intussusception (most common), S-shaped rectum or corkscrew rectum.