Prolapse
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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 generally reserved for organs protruding through the vagina, or for the misalignment of the valves of the heart.
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Vaginal prolapse
Prolapse can involve several structures within the pelvis:
- The vagina
- The bladder
- The uterus (or the "stump" when the uterus itself has been removed by hysterectomy)
- The rectum
- The cavum Douglasi without the rectum
- A combination of the above
- A special case is "inversio uteri" (inversion of the uterus), a complication of childbirth
Symptoms include pain, incontinence of urine and/or feces, discomfort in specific positions (standing, bicycling).
Diagnosis is by history and physical examination. When generalised weakness of the pelvic floor is suspected, additional tests might be considered. When incontinence is a feature, urodynamics may give some information on the interplay between prolapse and the incontinence.
Types of vaginal prolapse
- cystocele (bladder into vagina)
- enterocele (small intestine into vagina)
- rectocele (rectum into vagina)
- urethrocele (urethra into vagina)
- uterine prolapse (uterus into vagina)
- vaginal vault prolapse (roof of vagina, after hysterectomy)
Therapy
Vaginal prolapses must be treated according to the severity of symptoms. They can be treated:
- With conservative measures (changes in diet and fitness, Kegel exercises, etc.)
- With a pessary, to provide support to the weakened vaginal walls
- With surgery
Rectal prolapse
- Rectal prolapse occurs when the rectum protrudes through the anus.
Heart valve prolapse
Oviduct Prolapse
- An often fatal condition in egg-laying birds. When an egg is laid, the vagina everts through the cloaca to deliver the egg. Large eggs and avian obesity are contributors to this condition. Immediate veterinary assistance is paramount to the survival of a bird with prolapse. Even with immediate medical intervention the chances for survival are usually uncertain. Untreated birds will begin to tear at the injury site. Other flockmates will begin to cannibalise the prolapse area. This behaviour is commonly known as pickout.it:Prolasso