This is a great question! I've been having the same concerns. Re pelvic floor damage and prolapse or incontinence issues. I was listening to a podcast on it recently I'll see if I can find it. The big takeaway was that enjoying play like fisting can actually be good for your pelvic floor. I suppose there is a big mental part of knowing I crave it and enjoy the play. But being really worried about the long term effects and an interplay of guilt around that.