What causes vaginal wall prolapse?

Vaginal wall prolapse is a phenomenon that women need to pay attention to, because this problem usually occurs because women have a long labor process during childbirth, as well as long-term constipation, and behaviors such as pushing down and holding the breath every time you defecate, which may lead to vaginal wall prolapse.

1. The anterior wall of the rectouterine pouch (Douglas fossa) is separated from the apex of the vagina by the peritoneum, vaginal wall and its connective tissue, and the position and tension of the apex of the vagina are supported by the uterosacral ligament and cardinal ligament. When the uterosacral ligament relaxes or the tension of the vaginal rectal fossa septum decreases, the posterior vaginal fornix between the uterosacral ligaments on both sides may bulge, forming upper vaginal prolapse (enteroceles); the bulging hernia bag may contain intestinal tract, greater omentum and ascites, but incarceration will not occur.

2. Posterior vaginal wall prolapse is less common than anterior vaginal wall prolapse. Childbirth causes the pubococcygeus muscle fibers and pelvic floor tissues that are closely interwoven between the vaginal and rectal fascia to overstretch or tear, resulting in the loss of the support function of the rectum, causing the anterior wall of the rectum to bulge toward the posterior wall of the vagina like a blind pouch, resulting in posterior vaginal wall prolapse with rectal prolapse. In addition, long-term constipation, pushing down and holding the breath during defecation, and old age and physical weakness can aggravate the degree of bulging. If the injury occurs in the pubococcygeus muscle fibers at a higher position, it can cause a recto-uterine hernia, and there is often an intestinal tube in the hernial sac, so it is also called enterocele.

3. For women who give birth vaginally, when the second stage of labor is prolonged, the recto-vaginal fascia and pubococcygeus muscle fibers are under pressure for a long time and overstretch or tear, causing the anterior wall of the rectum to bulge toward the posterior wall of the vagina like a pouch, resulting in posterior vaginal wall prolapse with rectal prolapse. Posterior vaginal wall prolapse is less common than anterior vaginal wall prolapse. Long-term constipation, pushing down and holding the breath during defecation, and old age and physical weakness can aggravate the degree of bulging. If the damage occurs to the higher pubococcygeus muscle fibers, it may cause a rectouterine hernia. There is often intestinal tract in the hernia sac, so it is also called enterocele.