Prolapse can be uterine or vaginal. The first commonly occurs after childbirth due to ligaments of support to the womb being stretched or torn during birth. Vaginal wall prolapse can be related to front wall involving urinary bladder (with multiple urinary symptoms) or back wall of vagina involving rectum (rectocele). Vaginal vault (top of vagina) can prolapse in women following hysterectomy. Symptoms of prolapse are mainly expressed as a feeling of lump or a bulge down below, pelvic discomfort, backache and occasionally sexual problem for both partners due to lack of muscle tone. Also urine problems as frequency, recurrent infection, difficulty in passing urine or uncontrollable loss of urine (stress incontinence). Difficulty in opening bowels and constipating is a problem related to rectocele and occasionally discharge and bleeding can happen. Treatment of prolapse depends on symptoms, degree of prolapse, age, marital status and desire for pregnancy. This usually is treated by surgical repair either with or without a mesh to support the prolapsed organ or indeed in some cases vaginal hysterectomy. Occasionally a vaginal pessary is used to correct prolapsed organs for those who are not fit for surgery or older women.
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