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Increased in intra-abdominal pressure stretching and tearing of the endopelvic fascia and the levator muscles and perineal body decreased perineal muscle tone stretching
PRECIPITATING FACTORS pregnancy multiparous women hypoestrogenism obesity, chronic pulmonary disease, smoking, constipation pelvic tumors, sacral nerve disorders, and diabetic neuropathy.
coital difficulty
vaginal spotting
rectal pressure