Abstract
The inter-relation of genital prolapse with the physiology of defaecation is complex and a ‘two-way’ phenomenon. The common anatomical defects are hernia of the pouch of Douglas (enterocele) and divarication of the levator ani muscles, with wasting and attenuation. When the vaginal vault and introitus are in apposition pulsion forces lead to extroversion of the vagina. At other times intussusception into the rectum leading to rectal procidentia may occur. An understanding of the anatomical changes is essential for the management of these difficult cases.
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