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Management of Rectal Prolapse

Management of Rectal Prolapse | ASCRS


Rectal prolapse, internal intussusception, and solitary rectal ulcer syndrome comprise a spectrum of anatomical abnormalities involving descent of full- or partial-thickness rectal wall associated with pelvic floor dysfunction. These conditions, although benign, can be extremely debilitating because of the discomfort of prolapsing tissue both internally and externally, associated drainage of mucus or blood, and the common occurrence of fecal incontinence or constipation. In patients with rectal prolapse, diastasis of the levator ani, an abnormally deep cul-de-sac, a redundant sigmoid colon, a patulous anal sphincter, and loss of the rectal sacral attachments are commonly found.  In times past, restoration of normal anatomy to treat rectal prolapse was considered a definition of success. However, the presence of multiple operations to correct this problem indicates that the achievement of excellent outcomes is somewhat elusive.