Rectal Prolapse

Rectal Prolapse

Rectal prolapse means complete rectal prolapse where the rectal walls have prolapsed to a degree where they protrude out of the anus and are visible outside the body.

Types

The different types of prolapse are as-Internal prolapse (internal intussusception). A full thickness or a partial rectal wall is affected but the prolapsed tissue does not pass out of the anus.

• External Prolapse- If they protrude from the anus and are visible externally. Full thickness, circumferential, true intussusception of the rectal wall which protrudes from the anus and is visible externally.

• Full-thickness rectal prolapse- A full thickness of the rectal wall protrudes through the anus.

• Mucosal prolapse- Protrusion of only the rectal mucosa (not the entire wall) from the anus.

• Circumferential- Where the whole circumference of the rectal wall prolapse.

• Segmental- Where only parts of the circumference of the rectal wall prolapse.

Grades of Prolapse

• Grade I: Non-relaxation of the sphincter mechanism

• Grade II:Mild intussusception

• Grade III:Moderate intussusception

• Grade IV:Severe intussusception

• Grade V: Rectal prolapsed

Causes

• Pelvic floor dysfunction

• Parasitic infections such as Amoebiasis, schistosomiasis

• Pregnancy

• Cystic fibrosis

• Pertussis (whooping cough)

• Neurologic disorders - Previous lower back or pelvic trauma/lumbar disk disease, cauda equina syndrome, spinal tumors, multiple sclerosis

• Disordered defecation (stool withholding)

• Previous surgery

• Diarrhea

• Benign prostatic hypertrophy

• Chronic obstructive pulmonary disease (COPD)

Symptoms of Rectal Prolapse

• Pelvic floor dysfunction

• Parasitic infections such as Amoebiasis, schistosomiasis

• Pregnancy

• Cystic fibrosis

• Pertussis (whooping cough)

• Neurologic disorders - Previous lower back or pelvic trauma/lumbar disk disease, cauda equina syndrome, spinal tumors, multiple sclerosis

• Disordered defecation (stool withholding)

• Previous surgery

• Diarrhea

• Benign prostatic hypertrophy

• Chronic obstructive pulmonary disease (COPD)

Treatment

• Laparoscopic procedures

• Perineal procedures

• Perineal rectosigmoidectomy