A rectal prolapse is a condition that affects mostly the elderly and the female sex.
It consists in the protrusion of the full thickness of the rectum outside the anal opening.
It is caused by the weakening of the ligaments that hold the rectum in place. It is usually precipitated by straining because of constipation, chronic use of laxatives or by a forceful episode of severe diarrhea. It is also very common in psychiatric patients.
The lining of the prolapsed bowel soon becomes very irritated, friable, bleeds easily and produces a large amount of mucus.
The inability to control bowel movements, also known as incontinence, is also almost always associated with the rectal prolapse.
The treatmentof rectal prolapse is always surgical and should be performed as early as possible, since waiting too long could cause permanent damage to the sphincter and its nerves. Incontinence to stools may then become more difficult or even impossible to correct.
More than l00 different surgical procedures have been proposed over the years
They fall into three general categories.
- Procedures that are designed to attach the rectum to other internal structures, often using sheets of plastic called mesh
- Procedures that are designed to resect that segment of rectum that has become external,
- Procedures that involve the application of plastic or metallic rings around the anus.
All of these procedures have their advantages and disadvantages and they need to be individualized to each patient.
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