Prolapse can refer to many different medical conditions other than rectal prolapse. Anismus may also occur with anorectal malformation, rectocele, rectal prolapse and rectal ulcer. Anal sphincter defects, rectal prolapse, and abnormal perineal descent may be detected. Connective tissue disorders predispose women to developing cystocele and other pelvic organ prolapse. Surgical approaches in rectal prolapse can be either perineal or abdominal. Complications that can arise from constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction. Fecal incontinence can both potentially improve or deteriorate after prolapse surgery. Individuals with mitral valve prolapse, particularly those without symptoms, often require no treatment. However, internal intussusception rarely progresses to external rectal prolapse. A possible relationship with mitral valve prolapse has been proposed. Pessaries are a treatment option for pelvic organ prolapse. Sphincter function in rectal prolapse is almost always reduced. Levatorplasty is performed to correct elvator diastasis which is commonly associated with rectal prolapse. Defecography may demonstrate associated conditions like cystocele, vaginal vault prolapse or enterocele. It is usually not necessary with obvious external rectal prolapse.