Prolapse. A word you might think had been borrowed from a Harry Potter spell! Far from magical, it conceals a reality that often goes unnoticed: either because we would rather not see it, or simply because we are unaware of this condition. To guard against it and understand everything about anal prolapse, let us look at the options open to us.
Detecting an anal prolapse
To defeat your enemy, you must know it. A maxim drawn from The Art of War, which applies well to the duel between women and prolapse. Between 11 and 19 % of them are likely to face this health problem during their lifetime.
So what exactly are we talking about? An organ prolapse, as prolapse is commonly known. It shows up as the downward sinking of the organs in the pelvic area (the bladder, the rectum and, more rarely, the uterus).
The different types of prolapse
There are different types of prolapse depending on the organ involved. We then speak of:
- rectocele for a descent of the rectum;
- Hysterocele for a descent of the uterus;
- cystocele for a descent of the bladder.
When the prolapse descends through the anus, we speak of anal prolapse. In practical terms, one or more organs literally come out of the body through the anus (generally the rectum).
In the same way, prolapse can also be vaginal when the organs slip through the vagina. Vaginal and anal prolapse are two distinct conditions but can share similar organ prolapse symptoms.
When can anal prolapse occur?
Anal prolapse can declare itself at different stages of a woman's life. This is particularly true for mothers of several children, for physiological reasons linked to the strain placed on the internal organs by successive pregnancies.
The same goes for menopausal women, this time for hormonal reasons linked to pelvic floor weakening. In cases of anal prolapse, the pelvic floor muscles supporting the rectum weaken, bringing on a sensation of pressure or descent.
Certain high-impact sports add a risk factor, as do nutritional deficiencies, obesity and a complicated delivery.
Surgery carried out in this region of the body is also sometimes the origin of a prolapse.
What are the symptoms of anal prolapse?
The symptoms of a possible prolapse are: discomfort in the lower abdomen, a sensation of pelvic floor heaviness, or even the feeling of a bulge in the vagina.
Sometimes urination problems appear (passing urine with an interrupted stream, for instance) or, in the more serious cases, pain, which can signal that the organ has come outside.
Which examinations detect a prolapse?
Beyond these signs that raise suspicion, a gynaecological examination allows the diagnosis to be made with certainty. A complementary vaginal examination, sometimes a rectal examination, make it possible to assess the severity of the prolapse.
Depending on the findings, a urodynamic assessment may be prescribed for the patient, in order to prevent urinary incontinence occurring alongside the correction of the prolapse.
Urine analysis and MRI also feature on the list of medical examinations potentially leading to surgery, when conservative measures are not enough.
Preventing, easing or curing an anal prolapse
Strengthening the pelvic floor to prevent prolapse
To reduce the threat of a prolapse before it arises, the thing to do is work your pelvic floor. Ladies, let us trust our famous "hammock".
By toning this group of muscles that hold the pelvic organs, there is, logically enough, a greater chance that they will stay in the place nature originally assigned them.
For this, you can call on a healthcare practitioner, or a physiotherapist specialising in pelviperineology.
Visualisation techniques for the pelvic floor
You can also exercise your pelvic floor using visualisation methods, such as the cave and drawbridge technique, which involves picturing the opening and closing movements of the vagina.
This option has the advantage of being done at home without any equipment, but it does have its limits.
Toning the pelvic floor to counter the feeling of heaviness
Another alternative to practise at home: pelvic floor rehabilitation with a connected probe. This solution rests on the principle of biofeedback; this type of rehabilitation requires the woman to contract her pelvic floor.
The probe acts as a sensor that detects the muscular effort and sends a signal to the associated mobile app so you can see your contractions in real time. Enough to launch rockets with your pelvic floor, no less!
The app offers different worlds to train in, playful or more medical. And the exercises are in fact based on medical protocols, presented in the form of some thirty games.
Adapting your lifestyle
This pelvic floor rehabilitation is also worth practising if the prolapse is already present, but neither too established nor too severe. Rehabilitation then allows the patient to avoid complications.
These efforts will be combined with weight loss where there is excess weight, as well as with adjusting your sporting activities, to favour sports that are gentle on the pelvic floor, such as swimming.
Other options for managing an anal prolapse
Wearing a pessary
Beyond these lifestyle changes, you can turn to a medical helping hand: the pessary.
This device is there to compensate for the weakness of the pelvic floor, but its position inside the vagina can be uncomfortable for long-term use and it is generally recommended as a temporary solution.
Fitting tapes
To manually put back in place the organs affected by a prolapse, there is the surgical method known as tapes, which are positioned on the woman's organs through abdominal surgery.
More rarely, the practitioner chooses to position a mesh via the vaginal route. Either a urologist or an obstetric surgeon can perform these two types of operation.
More common than people think, anal prolapse sometimes takes time to declare itself through identifiable symptoms. So be, as far as possible, consistent with your annual appointments with your healthcare professional. The best monitoring in this area remains listening to your body and to anything that changes abnormally from the usual.
Sources
- Prolapsus et statique pelvienne, Nizar Kaafarani (Gynécologie Tarbes - Polyclinique Ormeau), Septembre 2026 (Consulté), Fiche d'information médicale (gynecologie-tarbes.com).
- Evaluation, Diagnosis, and Medical Management of Rectal Prolapse, Jamie A Cannon, February 2017, Clinics in Colon and Rectal Surgery 30(1):16-21 – link
- Evaluation and surgical treatment of rectal prolapse: an international survey, H A Formijne Jonkers, W A Draaisma, S D Wexner, I A M J Broeders, W A Bemelman, I Lindsey, E C J Consten, January 2013, Colorectal Disease 15(1):115-9 – link
- Anorectal emergencies, Varut Lohsiriwat, July 2016, World Journal of Gastroenterology 22(26):5867-78 – link
- Conservative prevention and management of pelvic organ prolapse in women, Suzanne Hagen, Diane Stark, December 2011, Cochrane Database of Systematic Reviews 2011(12):CD003882 – link
- Epidemiology and outcome assessment of pelvic organ prolapse, Matthew D Barber, Christopher Maher, November 2013, International Urogynecology Journal 24(11):1783-90 – link
