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A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. [2] However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed section is visible externally, and whether the full or only partial thickness of the rectal wall is involved.
The procedure reduces constipation and fecal incontinence in patients with rectal prolapse or rectal intussusception, and has a low rate of complications and recurrence. [64] The procedure is able to correct multiple anatomical defects associated with vaginal and rectal prolapse, as well as improving function in terms of continence and defecation.
Rectal prolapse is a condition in which part of the wall or the entire wall of the rectum falls out of place. Rectal prolapse can be a medical emergency. In some cases, the rectum may protrude. Symptoms of a rectal prolapse may be: Leakage of stool; Bleeding, anal pain, itching, irritation; Tissue that protrudes from the rectum
The rectum shortens as feces are pushed into the anal canal and peristaltic waves push the feces out of the rectum. Relaxation of the internal and external anal sphincters allows the feces to exit from the anus, finally, as the levator ani muscles pull the anus up over the exiting feces.
Long term injury to the rectal mucosa and ischemic trauma are thought to be the main mechanisms. [5] In a report of 36 patients with SRUS, the underlying cause was internal prolapse (intussusception) in 20 patients, external rectal prolapse in 14 patients, and dyssynergic defecation (anismus) in 2 patients. [7]
The equivalent structure in males is the rectovesical pouch, which is the pocket formed by the reflections of the peritoneum from the rectum to the male bladder. In terms of pelvic organ prolapse, a cul-de-sac hernia is located in the posterior compartment of the pelvis. [5]
External rectal prolapse may give symptoms of obstructed defecation syndrome, fecal incontinence, or both, [17] [6] Other symptoms are bloody or mucous rectal discharge. [6] Relative indications are: Internal rectal prolapse (rectal intussusception), if it causes symptoms. [20] Anterior rectocele, if large and causing symptoms. [5]
Severe cases may cause vaginal bleeding, intermittent fecal incontinence, or even the prolapse of the bulge through the mouth of the vagina, or rectal prolapse through the anus. Digital evacuation, or, manual pushing, on the posterior wall of the vagina helps to aid in bowel movement in a majority of cases of rectocele.