prolapsus

Prolapsus, in medical terminology, refers to the descent or protrusion of a body part from its normal position due to weakening of supporting tissues or increased intraabdominal pressure. The term derives from Latin, meaning a falling forward or downward. Prolapsus can affect various organs, most commonly those within the pelvic floor or the gastrointestinal tract.

Common forms include uterine prolapse, vaginal vault prolapse after hysterectomy, cystocele (bladder prolapse into the vagina), and rectal prolapse (prolapsus ani) where part of the rectal wall protrudes through the anus. Other conditions, such as enterocele (small intestine herniation into the vaginal canal), are grouped under pelvic organ prolapse. The condition can be described as partial or complete, depending on the extent of descent and which layers of tissue are involved.

Causes and risk factors include childbirth-related pelvic floor damage, aging, obesity, chronic coughing or constipation, heavy manual labor, prior pelvic surgery, and connective tissue disorders. A history of multiple pregnancies or menopause increases risk, and certain activities or conditions that raise intraabdominal pressure can contribute to development.

Symptoms vary by location but often include a sense of fullness or bulge in the vagina or anus, pelvic or back pressure, urinary symptoms (incontinence or retention), fecal incontinence or constipation, and discomfort during sexual activity. Diagnosis is typically based on a pelvic examination; imaging studies such as defecography, MRI, or ultrasound may be used in selected cases to assess involvement of surrounding structures.

Treatment ranges from conservative to surgical. Conservative options include pelvic floor exercises, weight management, treating constipation, and the use of a pessary to support the prolapsed organ. When symptoms are bothersome or anatomy is severely affected, surgical repair may be performed, including vaginal wall repair (colporrhaphy), sacrocolpopexy, or abdominal/vaginal approaches for vaginal vault prolapse; for rectal prolapse, procedures such as Delorme, Altemeier, or ventral rectopexy are used. Prognosis varies with type and severity; recurrence is possible and long-term follow-up may be necessary.