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The pelvic floor (pelvic diaphragm) can be divided into 4 compartments: Anterior or urinary (bladder, bladder neck, and urethra), Middle or genital (vagina and uterus in women, prostate in men), Posterior (anus, anal canal, sigmoid, and rectum), and Peritoneal (endopelvic fascia and perineal membrane). [40]
Treatment depends on the severity of the problem, and may include non-surgical methods such as changes in diet (increase in fiber and water intake), pelvic floor exercises such as Kegel exercises, use of stool softeners, hormone replacement therapy for post-menopausal women and insertion of a pessary into the vagina.
Many studies showed that women are affected more commonly than men, [5] but this can be at least partly explained by men's reluctance to seek medical advice concerning rectal pain. [6] Data on the number of people affected vary, but prevalence may be as high as 8–18%.
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [ 14 ]
The most common signs and symptoms are bleeding, which can vary from minor to severe, rectal prolapse and incomplete evacuation (35%-76% of cases). [4] According to one report, constipation is present in about 55% of cases, but diarrhea is present in 20%–40% of cases. [1] Reported symptoms are: Hematochezia (lower gastrointestinal bleeding).
Anal fissures occur when there is a split or tear in the rectal opening, says Soma Mandal, MD, an internist at Summit Medical Group in Berkeley Heights, New Jersey. They usually crop up after an ...
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