Materiały źródłowe

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

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

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

• #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 loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] Non-modifiable risk factors: e.g., advanced age and genetics. […] Modifiable risk factors: These include greater parity, history of vaginal delivery, history of pelvic surgery, obesity, level of education, constipation, and conditions that increase intra-abdominal pressure chronically such as COPD or a chronic cough. […] Age, BMI, parity, and vaginal delivery are the most well-documented risk factors.

• #1 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

• #1 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  Genetics. Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Childbirth. 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. […] Aging. Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Obesity. Extra body weight places stress on pelvic floor tissues.

• #1 Rectocele: Types, symptoms, causes, and diagnosis

  https://www.medicalnewstoday.com/articles/189696

  The more vaginal deliveries a woman has had, the more chance she has of developing a rectocele. […] Those who have never given birth can also develop a rectocele. […] The following are risk factors: a drop in estrogen levels at menopause, making pelvic tissues less elastic; a hysterectomy or other pelvic surgery; chronic constipation; long-term coughing, such as in chronic bronchitis; sexual abuse during childhood; being obese or overweight; regularly lifting heavy objects. […] If a person undergoes several gynecological or rectal surgeries, this can also weaken the pelvic floor and lead to a rectocele. […] In men, a rectocele can develop as the result of a prostatectomy, which is the removal of the prostate gland, as a treatment for prostate cancer.

• #1 Pelvic Organ Prolapse: Types, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24046-pelvic-organ-prolapse

  Having a heavier body weight. Studies have shown that people who have overweight or obesity are more likely to develop POP than people who are within a weight range that’s healthy for them. […] Long-term pressure in your abdominal cavity. Pressure on your pelvic floor muscles can weaken them. Chronic constipation, chronic coughing and frequent heavy lifting all increase your chance of developing POP. […] Family history. Research into the genetic components of POP is ongoing, but it’s possible that you inherited a weaker pelvic floor. […] Connective tissue diseases. People with conditions like Ehlers-Danlos syndrome, Marfan syndrome or joint hypermobility syndrome are at risk of POP.

• #1 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.

• #1 Rectocele: Types, symptoms, causes, and diagnosis

  https://www.medicalnewstoday.com/articles/189696

  A rectocele is a type of pelvic organ prolapse. Other names for a rectocele are a posterior vaginal wall prolapse or proctocele. A rectocele occurs when the supporting ligaments and muscles weaken in the pelvic floor. […] Childbirth, age, and a range of other factors can cause the normally tough, fibrous, sheet-like divider between the rectum and vagina to weaken. […] A rectocele usually happens with pregnancy and childbirth, but the risk also increases with age, and other factors can play a role. […] The underlying cause is a weakening of the pelvic support structures and of the rectovaginal septum, the layer of tissue that separates the vagina from the rectum. […] It is more likely to occur as a result of childbirth if the baby was large (weighing over 9 pounds) if labor was prolonged, or if there was a multiple birth, for example, twins.

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

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

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] Pregnancy and childbirth: Vaginal childbirth, especially multiple births, can damage or weaken your pelvic floor. […] Aging: Your pelvic floor can weaken over time. […] Chronic cough or bronchitis: Prolonged coughing associated with asthma, smoking and respiratory disease can also strain your pelvic floor over time, making you more susceptible to rectocele. […] Chronic constipation: Bearing down or straining too hard to poop can weaken your pelvic muscles over time.

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

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

  Repeated heavy lifting. Having a job that involves frequent heavy lifting can place too much strain on your pelvic floor muscles, causing them to stretch and weaken. […] Having a heavier body: Having obesity can increase your risk of rectocele. […] Previous surgery: Surgeries involving your pelvic organs (like a hysterectomy) may damage the tissue in your pelvic floor.

• #1

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectocele

  A rectocele is a bulging of the front wall of the rectum into the back wall of the vagina that may interfere with emptying of stool from the rectum. […] Rectoceles are usually caused by thinning of the rectovaginal septum (the tissue between the rectum and vagina) and weakening of the pelvic floor muscles. […] There are many things that can lead to weakening of the pelvic floor, including: Vaginal deliveries, Trauma from vaginal delivery (e.g. the use of forceps or vacuum during delivery, tearing or episiotomy, which is a surgical cut in the muscular area between the vagina and the anus made just before delivery), History of constipation, Chronic straining with bowel movements, Gynecological (e.g. hysterectomy) or rectal surgeries.

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

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

  Rectocele and other forms of POP are the result of women attaining an erect bipedal posture. Etiologically, most cases are the result of vaginal childbirth and chronic increases in intra-abdominal pressure (such as chronic constipation). In some patients, rectocele is thought to develop as a result of congenital or inherited weaknesses within the pelvic support system. […] A number of iatrogenic factors may contribute to POP, including failure to adequately correct all pelvic support defects during pelvic reconstructive surgery. In some patients, the failure to reattach the endopelvic fascia to the perineal body at the time of vaginal delivery leads to a site-specific defect in the endopelvic fascia. Additionally, procedures that alter the direction of pelvic forces can cause areas to prolapse that previously had been adequately supported. Examples include (1) ventral suspensions of the urethra, uterus, or vagina that increase exposure of the cul-de-sac to increases in intra-abdominal pressure; (2) posterior fixation of the vaginal apex; (3) failure to detect and correct an occult enterocele; and (4) excessive shortening of the vagina.

• #1 Posterior prolapse (Rectocele) –

  https://colorectalcenter-dcimch.com/pelvic-floor-disorder/posterior-prolapse-rectocele/

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Many women with posterior vaginal prolapse also have prolapse of other pelvic organs, such as the bladder or uterus.

• #1 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. […] Defects of pelvic support often do not occur in isolation.

• #1 Rectocele | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectocele

  Some of the causes of a rectocele include vaginal childbirth, hysterectomy, pelvic surgery and chronic constipation. […] A rectocele may occur by itself or present alongside other pelvic abnormalities, such as a prolapsed bladder (cystocele). […] Some of the events that may weaken or thin the rectovaginal septum and cause a rectocele include: Vaginal (normal) childbirth, Giving birth to multiple babies, A long and difficult labour, Assisted delivery during childbirth, including the use of forceps, Tearing during childbirth, particularly if the tear extended from the vagina to the anus, Episiotomy (a surgical cut made to enlarge the vaginal opening during childbirth to avoid injury to mother and baby), particularly if the cut extends to the anus, Hysterectomy, Pelvic surgery, Chronic constipation, Straining to pass bowel motions, Advancing age, as older women are more prone to rectocele.

• #1 Bowel Dysfunction –

  https://urogynaecology.com.au/bowel-dysfunction/

  Women with pelvic organ prolapse often experience bowel symptoms that may or may not be related to the vaginal prolapse. […] Many women with vaginal prolapse also have difficulty with complete bowel evacuation. This may manifest as sensation of incomplete bowel evacuation were the faeces may become trapped in the rectocoele (bowel prolapse into the vagina) as seen in the diagram. […] Women who have impaired defecation and a rectocoele can be confident that a posterior vaginal repair is very likely to be effective in correcting the faeces being entrapped in the rectocele. […] Approximately 10% of women with vaginal prolapse experience faecal incontinence and generally the bowel leakage is not related to the vaginal prolapse. […] Constipation is related to prolonged and slow transit of the faeces through the bowel and is not caused by vaginal prolapse.

• #1 Bowel Dysfunction –

  https://urogynaecology.com.au/bowel-dysfunction/

  Women undergoing prolapse surgery should understand the importance of correcting and managing the constipation to decrease the risk of recurrence of the vaginal prolapse. […] The prolapse is likely to be at least partially caused by the constipation. […] The constipation will not be resolved by the prolapse surgery. […] Ongoing post-operative management of constipation is required to minimise the risk of prolapse recurrence.

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

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

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] Pregnancy and childbirth: Vaginal childbirth, especially multiple births, can damage or weaken your pelvic floor. […] Aging: Your pelvic floor can weaken over time. […] Chronic cough or bronchitis: Prolonged coughing associated with asthma, smoking and respiratory disease can also strain your pelvic floor over time, making you more susceptible to rectocele. […] Chronic constipation: Bearing down or straining too hard to poop can weaken your pelvic muscles over time.

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

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

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

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

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

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] 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. […] Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Extra body weight places stress on pelvic floor tissues.

• #2

  https://www.kuh.ku.edu.tr/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/posterior-vaginal-prolapse-rectocele

  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. […] Genetics. Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Childbirth. 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. […] Aging. Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Obesity. Extra body weight places stress on pelvic floor tissues.

• #2 Posterior Vaginal Prolapse (Rectocele) – Symptoms, Causes, & Treatment – blog.cult.fit

  https://blog.cult.fit/articles/rectocele

  A rectocele is a bulge or herniation that appears on the front of the rectum and goes into the posterior wall of the vagina. […] One of the most common rectocele causes is pregnancy and childbirth. In this condition, the ligaments, fascia, and the muscles that support the vagina get stretched and become weak due to labor and delivery. The chances of rectoceles increases as the number of pregnancies increases. […] The other causes can be weak muscles in the pelvic area which makes such women more prone to rectocele. […] Reduced nerve function and loss of muscle mass and elasticity due to the natural process of aging can also cause rectocele. […] Menopause and drop in estrogen levels lead to loss of elasticity of pelvic muscles and hence can cause rectocele.

• #2

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/

  Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and cannot hold the organs in place firmly. […] A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse. […] These include: pregnancy and childbirth especially if you had a long, difficult birth, or if you gave birth to a large baby or multiple babies; getting older and going through the menopause; being overweight; having long-term constipation or a long-term health condition that causes you to cough and strain; having a hysterectomy; a job that requires a lot of heavy lifting. […] Some health conditions can also make a prolapse more likely, including: joint hypermobility syndrome; Marfan syndrome; Ehlers-Danlos syndromes.

• #2 Posterior vaginal prolapse (rectocele)

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20314570

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

• #2 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.

• #2 Posterior vaginal prolapse (rectocele)

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20314570

  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.

• #2 Rectocele | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectocele

  Some of the causes of a rectocele include vaginal childbirth, hysterectomy, pelvic surgery and chronic constipation. […] A rectocele may occur by itself or present alongside other pelvic abnormalities, such as a prolapsed bladder (cystocele). […] Some of the events that may weaken or thin the rectovaginal septum and cause a rectocele include: Vaginal (normal) childbirth, Giving birth to multiple babies, A long and difficult labour, Assisted delivery during childbirth, including the use of forceps, Tearing during childbirth, particularly if the tear extended from the vagina to the anus, Episiotomy (a surgical cut made to enlarge the vaginal opening during childbirth to avoid injury to mother and baby), particularly if the cut extends to the anus, Hysterectomy, Pelvic surgery, Chronic constipation, Straining to pass bowel motions, Advancing age, as older women are more prone to rectocele.

• #2 Rectocele – Causes, Symptoms and Treatment Options – Dr. Deepa Ganesh

  https://deepaganesh.com/rectocele-causes-symptoms-and-treatment-options/

  If the baby to be delivered is large or if the labour takes a lot longer than usual, the tearing of muscles is more. […] Chronic cough can also put pressure on the muscles in the pelvis region. […] Constipation and the pressure put on the pelvis region to empty your bowels can also cause rectocele. […] Improper way of lifting weight by putting pressure/weight on the abdominal or lower back instead of legs can result in prolapse. […] Being overweight or obese also puts more pressure in the pelvis region. […] In women reaching or who have attained menopause, the muscles in the pelvis region lose elasticity and strength due to lower production of estrogen. […] Old age is also a factor due to which the pelvic muscles become weak along with all other muscles in the body. […] Surgery to the pelvis region (one or multiple) can hurt the pelvis muscles and if the muscles don’t regain their strength that can result in prolapse. […] Rectocele is commonly found in women but is found in men too. Surgery done to remove prostate (to stop prostate cancer or any other reason), can also lead to rectocele.

• #2

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectocele

  A rectocele is a bulging of the front wall of the rectum into the back wall of the vagina that may interfere with emptying of stool from the rectum. […] Rectoceles are usually caused by thinning of the rectovaginal septum (the tissue between the rectum and vagina) and weakening of the pelvic floor muscles. […] There are many things that can lead to weakening of the pelvic floor, including: Vaginal deliveries, Trauma from vaginal delivery (e.g. the use of forceps or vacuum during delivery, tearing or episiotomy, which is a surgical cut in the muscular area between the vagina and the anus made just before delivery), History of constipation, Chronic straining with bowel movements, Gynecological (e.g. hysterectomy) or rectal surgeries.

• #2 Posterior Vaginal Prolapse – Symptoms | Causes | Diagnosis | Treatment | Complications | Prevention

  https://www.icliniq.com/articles/womens-health/posterior-vaginal-prolapse

  Chronic Constipation – Straining too hard to empty the bowel can weaken the pelvic muscles over time. […] Chronic Cough – Prolonged coughing associated with smoking, asthma, and respiratory disease can also strain the pelvic floor over time. […] Being Overweight or Obese – Having obesity can increase the risk of rectocele. […] Previous Surgery – Surgeries involving the pelvic organs like hysterectomy can damage the tissue of the pelvic floor muscle.

• #2 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

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

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

  Genital atrophy and hypoestrogenism also play important contributory roles in the pathogenesis of prolapse. […] However, the exact mechanisms are not completely understood. Prolapse may potentially result from pelvic tumors, sacral nerve disorders, and diabetic neuropathy. […] Other medical conditions that may result in prolapse are those associated with increases in intra-abdominal pressure (eg, obesity, chronic pulmonary disease, smoking, constipation). […] Certain rare abnormalities in connective tissue (collagen), such as Marfan disease, have also been linked to genitourinary prolapse. […] A thorough evaluation and definition of all support defects is of critical importance because most women with pelvic organ prolapse have multiple defects.

• #2

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectocele-expanded-information

  A rectocele is a herniation (bulge) of the front wall of the rectum into the back wall of the vagina. […] The exact cause of a rectocele is unknown, but symptomatic rectoceles usually occur in conjunction with weakening of the pelvic floor. There are many things which can lead to weakening of the pelvic floor, including advanced age, multiple vaginal deliveries and birthing trauma during vaginal delivery (e.g. forceps delivery, vacuum delivery, tearing with a vaginal delivery, and episiotomy during vaginal delivery). […] In addition, a history of chronic constipation and excessive straining with bowel movements are thought to play a contributory role in developing a rectocele. […] Multiple gynecological or rectal surgeries can also lead to weakening of the pelvic floor and rectocele formation.

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

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

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Rectoceles were previously thought to be a condition affecting only multiparous women, resulting from obstetric damage or increased tissue laxity with aging and menopausal atrophy. More recently, rectoceles and enteroceles were noted to occur in approximately 40% of asymptomatic parous women.

• #2 Rectocele (prolapsed rectum) – Pelvic organ prolapse – Stage 0 to 4

  https://theflowerempowered.com/knowledge-portal/pelvic-organ-prolapse/rectocele/

  A rectocele (also known as a posterior prolapse) is a hernia on the back wall of the vagina resulting in the rectum bulging into the vaginal passage. […] If you are suffering from one type of pelvic organ prolapse, the pull on your organs and connective tissues can also cause other prolapses to occur. […] Straining from constipation can increase the stage of pelvic organ prolapse due to the increase in intraabdominal pressure. […] Having a pelvic organ prolapse is an indication that the pelvic floor is sitting lower than normal. It usually also indicates that the connective tissue structures within the pelvis have are being stretched/pulled. […] The treatment for rectocele, like most other forms of prolapse falls into one of two categories; conservative (non-surgical) and invasive (surgical). Surgical options are generally only advised when the rectocele is severe (grade 3 or 4).

• #2 Bowel Dysfunction –

  https://urogynaecology.com.au/bowel-dysfunction/

  Women undergoing prolapse surgery should understand the importance of correcting and managing the constipation to decrease the risk of recurrence of the vaginal prolapse. […] The prolapse is likely to be at least partially caused by the constipation. […] The constipation will not be resolved by the prolapse surgery. […] Ongoing post-operative management of constipation is required to minimise the risk of prolapse recurrence.

• #3 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] 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.

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