Protrusion of an internal organ out of its normal place, usually of the rectum or uterus outside the body when supporting muscles weaken. The membrane lining the rectum can push out through the anus, most often in old people with constipation who strain during defecation. Chronic rectal prolapse requires surgical repair. The uterus may prolapse into the vagina after gravity adds to weakness from childbirth injuries. Temporary supports and pelvic exercises can relieve mild uterine prolapse, but severe prolapse may require hysterectomy.
Learn more about prolapse with a free trial on Britannica.com.
Prolapse literally means "To fall out of place." In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina, rectum, or for the misalignment of the valves of the heart. A spinal disc herniation is also sometimes called disc prolapse. Relating to the uterus, prolapse condition makes the organ extend inferiorly into the vagina causing weakened muscles.
Mitral valve prolapse (MVP) is a valvular heart disease characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole.
Rectal prolapse is a condition in which part of the wall or the entire wall of the rectum falls out of place. In some cases, the rectum may stick out of the body (protrusion).
There are three types of rectal prolapse.
There are multiple causes of rectal prolapse. A life long habit of straining to have bowel movements, stresses involved in childbirth, weakening of the anal sphincter muscle, and/or weakening of the ligaments that support the rectum are frequent causes. Neurological problems, such as spinal cord transaction or a spinal cord disease, can also lead to prolapse. In rare cases there may be a genetic predisposition. In most cases, though, no single cause can be identified.
Symptoms of a rectal prolapse may be:
Other accompanying symptoms may be:
Treatment should be aimed at avoiding constipation and avoiding straining to have a bowel movement. A diet rich in fiber and drinking 6 to 8 glasses of decaffeinated fluids every day will assist in keeping stools soft. In some cases physical therapy with biofeedback can assist with avoiding straining. If anal sphincter muscles are weak, Kegels are recommended. Physical therapy can also help strengthen weakened ligaments and anal sphincter muscles.
Two types of surgery are used to treat a complete prolapse. A surgeon may operate through the belly to secure part of the large intestine or rectum to the inside the abdominal cavity (rectopexy). Sometimes the surgeon removes the affected part of the intestine.
Surgery also can be done through the area between the genitals and the anus (perineum) to remove the prolapsing tissue
Surgery is most often successful for people who still have some control over their bowel movements. If the anal sphincter is damaged, surgery may correct the prolapse but not be able to completely correct fecal incontinence (lack of control of bowel movements). In some cases, fecal incontinence improves after prolapse surgery and in some cases fecal incontinence worsens.