Materiały źródłowe

• #1 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] The incidence and prevalence of all pelvic organ prolapse are unknown because many patients are asymptomatic and do not seek out medical care for their prolapse. Another reason for unknown prevalence is the lack of a comprehensive classification system for rectoceles. For pelvic organ prolapse in general, the incidence is around 67% of parous women. […] About 11.1% of women by the age of 80 years have undergone surgical intervention for pelvic organ prolapse.

• #2 Posterior Vaginal Prolapse (Rectocele) – Giggles – Giggles

  http://giggles.co.in/departments/posterior-vaginal-prolapse-rectocele/

  Posterior vaginal prolapse is a common medical condition that might cause severe discomfort. […] Rectoceles are typical, possibly more so than we realize. Minor rectoceles frequently don’t produce symptoms. Thus, many people are unlikely to seek medical attention for this condition or get a diagnosis. […] Rectocele can get worse if left untreated. Not all rectocele cases need surgery. Despite this, you might need to consume more fiber, conduct daily Kegels, utilize a pessary, etc., depending on how severe your rectocele is.

• #3 Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01304-6

  The aim of this study is to examine the relationship between rectalvaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). […] Patients with posterior vaginal prolapse staged III or IV in accordance with the POP Quantitation classification method who were scheduled for pelvic floor reconstructive surgery in the years 20162019 were included in the study. […] Symptomatic rectocele was significantly associated with older age (p0.01), a higher OD symptom score (p0.001), and a lower grade of apical prolapse (p0.001). […] The rectalvaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectalvaginal pressure gradient of 27.5 cm H2O was suggested to be the cut-off point of the elevated pressure gradient. […] Rectocele is a common condition in patients with POP, with a variant prevalence rate of 750%.

• #3 Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01304-6

  In the present study, it was found that the rectalvaginal pressure gradient was significantly elevated in patients with symptomatic rectocele, and a cut-off value of 27.5 cm H2O showed good sensitivity and specificity, especially when applied as an exclusion test. […] The study indicated that the rectalvaginal pressure gradient may be used as an objective factor in POP assessment. […] The merits of this study can be found in the adequate sample size, reliable diagnosis method, and blind method application. However, the study has several limitations: […] The rectalvaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectalvaginal pressure gradient of 27.5 cm H2O was suggested to be the cut-off point of the elevated pressure gradient.

• #4 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. […] Rectoceles may have a broader incidence than previously thought and may not be a result of parity. […] The most common causes of rectoceles are obstetric events. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Clinical patient complaints of bowel dysfunction vary from being asymptomatic to severe. […] Of women with rectoceles, 80% are asymptomatic and can be diagnosed only on physical examination. […] Defecography is believed useful by some because it provides objective outcomes and identifies anatomic abnormalities.

• #4 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  Defecography is a good diagnostic tool to help exclude other defecation disorders that may increase the risk of recurrence of symptoms despite anatomic repair. […] When the clinical diagnosis is made, potentially confirmed by ancillary studies, the decision to operate or to treat conservatively must be made. […] Most nonsurgical treatments consist of proper bowel training, following an active lifestyle, and eating an appropriate amount of dietary fiber. […] The only nonsurgical therapy available for prolapse symptoms is estrogen replacement therapy in postmenopausal patients and the use of a vaginal pessary. […] Symptoms that predict good postoperative results include pelvic pressure and a vaginal bulge, vaginal digitalization or splinting (which occurs in 20-75% of symptomatic patients), and outlet obstruction constipation.

• #4 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  The colorectal literature noted that defecography showing a rectocele greater than or equal to 20 mm with symptoms is a good indicator for surgery; however, this finding has not been conclusive in all studies. […] Signs and symptoms that are predictive of a poor surgical outcome include a history of potent laxative use, incidence of preoperative pain, and large-volume rectoceles in women who previously had undergone hysterectomy. […] Few studies have addressed the long-term success of vaginal plastic procedures for treating rectoceles. […] Anatomic success rates ranged from 82% to 90% using the site-specific repair method. […] Rectoceles may be associated with sexual dysfunction preoperatively and postoperatively.

• #5 Genitourinary Prolapse (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/genitourinary-prolapse-pro

  Genitourinary prolapse epidemiology […] Pelvic organ prolapse is common, occurring in 40-60% of parous women. The exact incidence of genital prolapse may be difficult to determine, as many women do not seek medical advice. A woman’s lifetime risk of surgery for pelvic organ prolapse is 12-19%. 1 in 12 women in the community in the UK report symptoms of pelvic organ prolapse. In the UK, pelvic organ prolapse accounts for 20% of women waiting for major gynaecological surgery and is a leading indication for hysterectomy in postmenopausal women. Prolapse of the anterior vaginal wall is the most common type.

• #6 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0501/p1111.html

  Pelvic organ prolapse, or genital prolapse, is the descent of one or more of the pelvic structures (bladder, uterus, vagina) from the normal anatomic location toward or through the vaginal opening. Women of all ages may be affected, although pelvic organ prolapse is more common in older women. […] The prevalence of pelvic organ prolapse varies widely across studies, depending on the population studied and entry criteria. Women of all ages may be affected, although it is more common in older women. In the Women’s Health Initiative study, investigators found a 41.1 percent prevalence of pelvic organ prolapse at a standard physical assessment in postmenopausal women older than 60 years who had not had a hysterectomy. […] The cause of pelvic organ prolapse is multi-factorial, resulting from loss of the support maintained by a complex interaction among the levator ani, the vagina, and the connective tissue, as well as neurologic injury from stretching of the pudendal nerves that may occur during childbirth.

• #6 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0501/p1111.html

  Older terms describing pelvic organ prolapse (e.g., cystocele, urethrocele, rectocele) have been replaced because they imply an unrealistic certainty about the structures on the other side of the vaginal bulge, particularly in women who have had previous pelvic organ prolapse surgery. […] Most patients with pelvic organ prolapse are asymptomatic. Seeing or feeling a bulge of tissue that protrudes to or past the vaginal opening is the most specific symptom. […] Pelvic organ prolapse may progress with increasing body mass index. Weight loss does not reverse the prolapse. […] Management options for women with symptomatic pelvic organ prolapse include observation, pelvic floor muscle training, mechanical support (pessaries), and surgery. […] Surgery for pelvic organ prolapse may be obliterative or reconstructive.

• #7 Posterior vaginal defects (eg, rectocele): Clinical manifestations, diagnosis, and nonsurgical management – UpToDate

  https://www.uptodate.com/contents/posterior-vaginal-defects-eg-rectocele-clinical-manifestations-diagnosis-and-nonsurgical-management

  Posterior vaginal defects may be associated with: […] Rectocele (anterior protrusion of the rectum) […] Pelvic organ prolapse (POP) includes defects of the anterior, apical, and posterior vaginal wall. […] One series of 384 women undergoing surgical repair of POP reported the following types and frequencies of defects: anterior compartment only (40 percent), posterior compartment only (7 percent), apex only (6 percent), anterior and posterior compartments (16 percent), anterior compartment and apex (9 percent), posterior compartment and apex (5 percent), and all three compartments (18 percent).

• #8 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0801/p179.html

  Current recommendations characterize the site of prolapse as the anterior vaginal wall, posterior vaginal wall, and vaginal apex (apical prolapse). Apical prolapse is sometimes referred to as uterine or cervical prolapse when these structures are present; after total hysterectomy, prolapse of the vaginal cuff is referred to as vaginal vault prolapse1. Anterior prolapse is two and three times more common than posterior and apical prolapse, respectively.

• #8 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0801/p179.html

  Pelvic organ prolapse is defined by herniation of the anterior vaginal wall, posterior vaginal wall, uterus, or vaginal apex into the vagina; descent may occur in one or more structures.1 Prolapse of pelvic structures can cause a sensation of pelvic pressure or bulging through the vaginal opening and may be associated with urinary incontinence, voiding dysfunction, fecal incontinence, incomplete defecation, and sexual dysfunction. […] Although pelvic organ prolapse can affect women of all ages, it more commonly occurs in older women. The prevalence of pelvic organ prolapse increases with age until a peak of 5% in 60- to 69-year-old women.2 Some degree of prolapse is present in 41% to 50% of women on physical examination,3 but only 3% of patients report symptoms.2 Limited data suggest that prolapse progresses until menopause, with low rates of progression and regression thereafter.2,4,5 The number of women who have pelvic organ prolapse is expected to increase by 46%, to 4.9 million, by 2050.6

• #9 Tips & Tricks in Common Surgeries: Rectocele

  https://www.iuga.org/spotlight-v16-4/tips-tricks-in-common-surgeries-rectocele

  The current terminology for rectocele is posterior compartment prolapse. Surgical repair is recommended for symptomatic women where conservative management has failed or been refused, or in cases of advanced stage 3 or 4 prolapse. […] Posterior prolapse is less common than anterior prolapse (7% vs 40% [Olsen et al]). […] Evidence shows that the transvaginal approach is superior to the transanal approach using native tissue repair. […] Pre-operative investigations must be completed prior to surgery. […] There is no evidence of significant differences, thus, the procedure selected is the surgeons choice. […] The surgeon should choose the type of surgery based on his or her experience, as evidence has failed to show any significant difference between traditional repair and defect-specific repair.

• #10 Rectocele: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/268546-overview

  Pelvic organ prolapse (POP) is very common, and it is the indication for more than 200,000 surgeries in the United States annually. […] The number of women seeking care for POP is predicted to increase by 45% over the next few years. […] Ambulatory women have a reported prevalence rate of POP of 30-93%. […] Data on symptomatic women with prolapse are somewhat more robust. In a review of 149,544 women, Olsen et al found an 11.1% lifetime risk of surgery for POP or urinary incontinence. Approximately 40% of these women had posterior support defects. […] Thus, POP and rectocele are relatively common, although the supporting data are limited. The incidence of POP and rectocele increases with age, parity, and BMI. However, even nulliparous women may present with a clinically significant rectocele, albeit relatively uncommon.

• #11

  https://journals.lww.com/greenjournal/fulltext/2017/04000/practice_bulletin_no__176__pelvic_organ_prolapse.46.aspx

  Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP. Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years. Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50%. […] The purpose of this joint document of the American College of Obstetricians and Gynecologists and the American Urogynecologic Society is to review information on the current understanding of POP in women and to outline guidelines for diagnosis and management that are consistent with the best available scientific evidence.

• #12 Pelvic Organ Prolapse: Practice Essentials, Background, Problem

  https://emedicine.medscape.com/article/276259-overview

  The exact prevalence of pelvic organ prolapse is difficult to determine. However, the lifetime risk of requiring at least 1 operation to correct incontinence or prolapse is estimated at approximately 11%. […] About 200,000 inpatient procedures are performed annually in the United States. […] Symptoms of pelvic organ prolapse occur most frequently in women aged 70-79 years.

• #13

  https://link.springer.com/article/10.1007/s00192-012-1753-8

  Rectocoele is a common condition, which often leads to the need for surgical repair. […] Risk factors for rectocoele include high parity (especially large birth weights delivered vaginally), chronic raised intra-abdominal pressure (chronic cough, persistent heavy lifting, constipation), age and increased body mass index (BMI). […] It is likely that concomitant POP and rectal prolapse are more common than reported due to similarities in the risk factors for both. […] It has been suggested that women presenting with POP should be examined and assessed for evidence of rectal disorders (and vice versa), as it is likely that the number of women with concurrent genital and rectal prolapse is higher than reported. […] Therefore, regarding the consent process for rectocoele repair, perhaps we now need to add unmasking or development of new rectal prolapse as a complication of posterior compartment vaginal surgery.

• #14 Posterior vaginal prolapse (rectocele) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectocele/symptoms-causes/syc-20353414

  Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse. […] Anyone with a vagina can develop posterior vaginal prolapse. However, the following might increase the risk: Genetics. Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse.

• #14 Posterior vaginal prolapse (rectocele) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectocele/symptoms-causes/syc-20353414

  Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. Tears in the tissue between the vaginal opening and anus (perineal tears) or cuts that make the opening of the vagina bigger (episiotomies) during childbirth might also increase risk. Operative vaginal deliveries, and forceps specifically, increase the risk of developing this condition. […] To help keep posterior vaginal prolapse from getting worse, you might try to: Perform Kegel exercises regularly. These exercises can strengthen pelvic floor muscles. This is especially important after having a baby. Treat and prevent constipation. Drink plenty of fluids and eat high-fiber foods, such as fruits, vegetables, beans and whole-grain cereals. Avoid heavy lifting and lift correctly. Use your legs instead of your waist or back to lift. Control coughing. Get treatment for a chronic cough or bronchitis, and don’t smoke. Avoid weight gain. Ask your health care provider to help you determine the best weight for you. Ask for advice on how to lose weight, if needed.

• #15 Rectocele | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/rectocele-1?case_id=full-thickness-posterior-rectal-wall-prolapse-and-anterior-rectocele

  Rectocele refers to a herniation or bulge of the rectal wall, with the most common type being an anterior rectocele where the bulge is into the posterior vaginal wall in a female patient. Rectoceles can also occur posteriorly or laterally. Rectocele is the term most commonly used by colorectal surgeons, and the same entity is referred to as a posterior vaginal prolapse by urogynaecologists. […] Epidemiology […] Risk factors include obstetric trauma, hysterectomy, cystopexy, and chronic constipation. […] Associations include increasing age and parturition.

• #16 Pelvic organ prolapse: clinical review | GPonline

  https://www.gponline.com/pelvic-organ-prolapse-clinical-review/womens-health/article/1433744

  Pelvic organ prolapse refers to loss of support for the uterus, bladder or bowel, leading to prolapse of one or more of these compartments into the vagina. Prolapse can have a significant impact on the womans quality of life and body image. It is associated with disturbances to bowel, bladder and sexual function. […] It is estimated that up to 40% of women experience a degree of pelvic organ prolapse in their lifetime. The lifetime risk of undergoing prolapse surgery is 11% and up to 11% of patients will have a repeat operation within 11 years. It is likely that the number of women presenting with prolapse will increase. […] Risk factors for prolapse include the following. […] The risk of prolapse doubles with every decade of life. […] Pregnancy and childbirth are associated with pelvic organ prolapse. The incidence of prolapse is 50% in parous women and 2% in nulliparous women. The risk increases with the number of deliveries a woman has.

• #16 Pelvic organ prolapse: clinical review | GPonline

  https://www.gponline.com/pelvic-organ-prolapse-clinical-review/womens-health/article/1433744

  Symptomatic pelvic organ prolapse is most common among hispanic American women and least common in African American women. […] The increased risk of pelvic organ prolapse in obese women is likely because of the effects of chronic increased pressure on the pelvic floor. […] The increased risk of pelvic organ prolapse in women who smoke is likely because of the chronic cough associated with smoking. […] Jobs involving heavy lifting have been associated with pelvic organ prolapse. […] There is a strong association between chronic constipation and pelvic organ prolapse. […] Evidence suggests a link between menopause and development of pelvic organ prolapse. […] There is evidence of an increased risk of prolapse in women with a first degree relative who has pelvic organ prolapse. […] Patients with joint hypermobility syndrome and connective tissue disorders, such as Ehlers-Danlos and Marfan syndromes, have a higher incidence of pelvic organ prolapse.

• #17 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  FPOP is a common condition and has a lifetime risk for surgery of 10-20%. […] Vaginal childbirth is the main aetiological factor for FPOP. […] Posterior compartment prolapse may manifest with symptoms of obstructed defecation; rectocele (ie a diverticulum of the rectal ampulla) is the most common cause. […] If a rectocele is found in someone with bothersome obstructed defaecation, surgical treatment may be indicated even without symptoms of prolapse. […] The use of forceps, the primary risk factor for levator avulsion, is entirely avoided in some countries and institutions, demonstrating that this risk factor is eminently modifiable. […] There is some evidence that replacement of forceps by vacuum, as occurred in Denmark between 1960 and 1980, may substantially reduce the lifetime risk of prolapse surgery.

• #17 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  The main modifiable risk factor for pelvic floor trauma and later pelvic organ prolapse is forceps, whereas vacuum is not associated with increased risk. […] Many women are not bothered by their prolapse, especially once its benign and often non-progressive nature is explained. […] Referral to a gynaecologist or urogynaecologist is indicated if conservative treatment fails. […] FPOP is a common condition requiring surgery in 10-20% of women.

• #18 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  You can’t prevent a rectocele or pelvic organ prolapse. Still, you can put good practices into place that can strengthen your pelvic floor. […] Your outlook depends on your symptoms and how severe your prolapse is. Most people who receive surgery for rectocele experience symptom relief after their procedure. […] Rectocele can worsen without treatment. Not every rectocele requires surgery. Still, depending on the severity of your rectocele, you may need to increase your fiber intake, perform daily Kegel’s, use a pessary, etc. Follow the treatment plan that you and your provider decide works best.

• #19 Posterior vaginal prolapse (rectocele) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectocele/diagnosis-treatment/drc-20353419

  A diagnosis of posterior vaginal prolapse often happens during a pelvic exam of the vagina and rectum. […] You might fill out a questionnaire to assess your condition. Your answers can tell your health care provider about how far the bulge extends into the vagina and how much it affects your quality of life. This information helps guide treatment decisions. […] Treatment depends on how severe your prolapse is. Treatment might involve: […] If the posterior vaginal prolapse causes few or no symptoms, simple self-care measures such as performing Kegel exercises to strengthen pelvic muscles might give relief. […] Surgery to fix the prolapse might be needed if: […] Surgery often involves removing extra, stretched tissue that forms the vaginal bulge. Then stitches are placed to support pelvic structures.

• #20 Anterior and Posterior Vaginal Wall Prolapse – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/pelvic-organ-prolapse-pop/anterior-and-posterior-vaginal-wall-prolapse

  Posterior vaginal wall prolapse is commonly referred to as enterocele (small intestine and parietal peritoneum) and rectocele (rectum). […] Symptoms include pelvic or vaginal fullness, pressure, and a sensation of organs falling out. Organs may bulge into the vaginal canal or through the vaginal opening (introitus), particularly during straining or coughing. […] Diagnose enterocele or rectocele on pelvic examination by retracting the anterior vaginal wall and observing the posterior vaginal wall with the patient at rest and then with the patient straining, and with a rectovaginal examination. […] First-line conservative treatment options include pelvic floor physical therapy (for less severe pelvic organ prolapse) and pessaries, with surgical options available based on patient preference and clinical pelvic organ prolapse severity.

• #21 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] To help keep posterior vaginal prolapse from getting worse, you might try to perform Kegel exercises regularly. […] A diagnosis of posterior vaginal prolapse often happens during a pelvic exam of the vagina and rectum. […] Treatment depends on how severe your prolapse is. […] Surgery to fix the prolapse might be needed if pelvic floor strengthening exercises or using a pessary doesn’t control your prolapse symptoms well enough. […] Kegel exercises strengthen pelvic floor muscles. […] For posterior vaginal prolapse, you might need to see a doctor who specializes in female pelvic floor conditions.

• #22 Clinical challenges in the management of vaginal prolapse | IJWH

  https://www.dovepress.com/clinical-challenges-in-the-management-of-vaginal-prolapse-peer-reviewed-fulltext-article-IJWH

  For women with prolapse, one of the biggest clinical challenges is selecting which surgery to perform. […] If a woman has an isolated rectocele without any apical prolapse, surgical decision making can be fairly easy. Traditional posterior colporrhaphy uses stitches and the womans own tissue to reestablish support in the posterior vagina. Recurrence occurs in 7%14% of women after 1 year. […] Thus, at this time there are no data to support using mesh or graft augmentation for an isolated posterior compartment defect.

• #22 Clinical challenges in the management of vaginal prolapse | IJWH

  https://www.dovepress.com/clinical-challenges-in-the-management-of-vaginal-prolapse-peer-reviewed-fulltext-article-IJWH

  Pelvic organ prolapse (POP) is one of many pelvic floor disorders in women. Prolapse is a protrusion of the vaginal walls and/or uterus, resulting from descent of the pelvic organs. In general, vaginal prolapse includes multiple categories of pelvic support problems, such as uterine prolapse, posthysterectomy vaginal vault prolapse (enterocele), anterior vaginal wall prolapse (cystocele), and posterior vaginal wall prolapse (rectocele). These various support defects can occur in isolation or in combination with one another. […] Nearly 25% of women in the US suffer from pelvic floor disorders, and in the US the lifetime risk of undergoing a surgical procedure for prolapse or urinary incontinence is 11% by 80 years of age. […] Recent projections estimate that the number of women undergoing surgery for POP will increase to approximately 250,000 by 2050.

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