In medical terms, ‘Prolapse’ is a condition where the organs fall down or move out of their original place. Though prolapse is used to refer to conditions when organs fall through vagina or rectum, it can also refer to the valves that gets misaligned in the heart. Even a slip disc is referred to prolapse.
Types of Prolapse: (Limiting to Gynecology)
In women, there exists a divider like tissue between the rectum and the vagina. This is called ‘Rectovaginal Septum’ in medical terms. The front side wall of the rectum bulges and pushes the backside wall of the vagina. The tissue can become thin and weak over time due to reasons unknown resulting in a condition called ‘Rectocele’. When this bulging and pushing of walls is smaller, no symptoms are experienced. But when there is too much of bulge and displacement, following symptoms of Rectocele may be experienced:
Rectal Symptoms include difficulty with passing stools. There may be times when one may have to press against the back wall of the vagina to pass stools.
When the person is not able to pass stools smoothly, some pieces of stools may get stuck in the rectum (called stool trapping). However, as the body wants to pass those pieces off, you will end up making multiple trips to the toilet. At times, this may lead to incontinence when these pieces of stool just pass out when standing.
Vaginal Symptoms include a sense of bulge or feeling of fullness in the vagina. Sometimes, tissue may protrude out of the vagina, discomfort with sexual intercourse, vaginal bleeding.
Rectocele occurs usually with the weakening of the pelvic floor (muscles). There are several factors that can cause weakening of pelvic floor including age, multiple vaginal deliveries and birthing trauma during vaginal delivery.
Also, if the person has been experiencing chronic constipation and excessive straining with bowel movements, rectocele condition may show up.
The posterior vaginal wall is opened with the laser with minimal blood loss and pain. The rectovaginal septum is defined. The fascia is then plicated with delayed absorbable sutures. Use of the laser for dissection opens out the planes with minimal tissue trauma thereby promoting faster healing.
The Holmium Yag laser can be combined with Mesh for repair of the posterior vaginal wall. The fascial weaking can be repaired with sutures as in the above technique or needs bolstering when it is very weak. In fact there is a lot of data to say that mesh repair is better than no mesh in the case of the posterior vagina.
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