Editing Prolapse (section)

==Humans==

===Heart valve prolapse===

{{further|Mitral valve prolapse}}
The main type of prolapse of [[heart valve]]s in humans is [[mitral valve prolapse]] (MVP), which is a [[valvular heart disease]] characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole.

''Tricuspid valve prolapse'' can cause [[tricuspid regurgitation]].<ref name=agabegi2nd41>Page 41 in: {{cite book |author1=Elizabeth D Agabegi |author2=Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |isbn=978-0-7817-7153-5 |url-access=registration |url=https://archive.org/details/stepuptomedicine0000agab }}</ref>

===Rectal prolapse===
{{Main|Rectal prolapse}}
Rectal prolapse is a condition in which part of the wall or the entire wall of the rectum falls out of place. Rectal prolapse can be a medical emergency. In some cases, the rectum may protrude.

Symptoms of a rectal prolapse may be:
* Leakage of stool
* Bleeding, anal pain, itching, irritation
* Tissue that protrudes from the rectum

A surgeon may operate through the abdomen to secure part of the large intestine or rectum to the inside of the abdominal cavity ([[rectopexy]]).  Sometimes the surgeon removes the affected part of the intestine.

Surgery also can be done through the perineum (the area between the genitals and the anus) 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).  Fecal incontinence can both potentially improve or deteriorate after prolapse surgery.

If the lining has fallen out of the anus and is around 7&nbsp;cm or less, it should eventually retract back inside naturally, though the retraction can take up to four days.

=== Female genital prolapse ===

{{further|Uterine prolapse|Pelvic organ prolapse}}
Uterine prolapse (or pelvic organ prolapse) occurs when the female pelvic organs fall from their normal position, into or through the vagina. Occurring in women of all ages, it is more common as women age, particularly in those who have delivered large babies or had exceedingly long pushing phases of labor. Smoking, obesity, connective tissue disorders, upper respiratory disorders‚ and repetitive strain injuries can all increase prolapse risk. Minor prolapse can be treated with exercises to strengthen the pelvic floor muscles (pelvic physiotherapy); more serious prolapse, e.g., complete [[procidentia]], requires [[pessary]] use or reconstructive surgical treatment. Reconstructive pelvic prolapse surgery may be done without resorting to complete [[hysterectomy]] by hysteropexy,<ref>Price N., Slack A., Jackson S. "Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse." ''BJOG'' 2010;117:62–68. {{doi|10.1111/j.1471-0528.2009.02396}}. www.bjog.org</ref> the resuspension of the prolapsed uterus. Traditional gynecologic practice favors removal of the uterus or ovaries (or both) at the time of prolapse surgery, and one estimate states that of the 600,000 hysterectomies performed in the United States every year, 13 percent are for prolapse.<ref name=pelvicorganprolapse1>
{{cite news
 |url         = http://www.beautycallbooks.com/publications.htm
 |title       = Vaginal rejuvenation: sounds great. What is it?
 |publisher   = Beautycallbooks.com
 |access-date  = 2009-12-14
 |url-status     = dead
 |archive-url  = https://web.archive.org/web/20100403205934/http://www.beautycallbooks.com/publications.htm
 |archive-date = 2010-04-03
}}
</ref> However, there is concern that many of these hysterectomies may be unnecessary and that hysteropexy would suffice as a treatment instead.

===Pelvic floor prolapse===
The rectum or urinary bladder may prolapse as a result of changes in the integrity of connective tissue in the posterior or anterior vaginal walls, respectively, resulting in [[pelvic floor dysfunction|pelvic floor prolapse]]. Symptoms may include a feeling of pressure in the pelvis, or the visible protrusion of organs from the vagina. Prolapse is almost never painful, but the change in position of organs may cause urinary or bowel symptoms.

[[Pessary|Pessaries]] are a treatment option for pelvic organ prolapse.<ref name="AUSFive">{{Citation |author1 = American Urogynecologic Society|author1-link = American Urogynecologic Society |date = May 5, 2015 |title = Five Things Physicians and Patients Should Question |publisher = American Urogynecologic Society |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url = http://www.choosingwisely.org/societies/american-urogynecologic-society/ |access-date = June 1, 2015}}, which cites: 
*{{cite journal|last1=Culligan|first1=PJ|title=Nonsurgical management of pelvic organ prolapse.|journal=Obstetrics and Gynecology|date=April 2012|volume=119|issue=4|pages=852–60|pmid=22433350|doi=10.1097/aog.0b013e31824c0806|s2cid=21218937}}
*{{cite journal|last1=ACOG Committee on Practice|first1=Bulletins--Gynecology|title=ACOG Practice Bulletin No. 85: Pelvic organ prolapse.|journal=Obstetrics and Gynecology|date=September 2007|volume=110|issue=3|pages=717–29|pmid=17766624|doi=10.1097/01.aog.0000263925.97887.72|doi-access=free}}.</ref>

===Umbilical cord prolapse===
{{further|Umbilical cord prolapse}}
Umbilical cord prolapse occurs when the umbilical cord comes out of the uterus with or before the presenting part of the fetus. It is a relatively rare condition and occurs in fewer than 1% of pregnancies. Cord prolapse is more common in women who have had rupture of their amniotic sac. Other risk factors include maternal or fetal factors that prevent the fetus from occupying a normal position in the maternal pelvis, such as abnormal fetal lie, too much amniotic fluid, or a premature or small fetus. The concern with cord prolapse is that pressure on the cord from the fetus will cause cord compression that compromises blood flow to the fetus. Whenever there is a sudden decrease in fetal heart rate or abnormal fetal heart tracing, umbilical cord prolapse should be considered. Due to the possibility for fetal death and other complications, umbilical cord prolapse is considered an obstetric emergency during pregnancy or labor. Current management guidelines focus on quick delivery, which usually entails a cesarean section. With appropriate management, the majority of cases have good neonatal outcomes.