Surgical Management of Rectal Prolapse

- Introduction

Complete rectal prolapse is a disorder characterized by a full-thickness intussusception of the rectal wall, which protrudes externally through the anus. It is associated with a spectrum of coexisting anatomic abnormalities, such as diastasis of the levator ani, an abnormally deep cul-de-sac, a redundant sigmoid colon, a patulous anal sphincter, and loss or attenuation of the rectal sacral attachments. Some have hypothesized that the condition is associated with (and preceded by) internal rectal intussusception or a traumatic solitary rectal ulcer, although these associations have never been clearly proven, ⁽¹⁾.

Although rectal prolapse is a benign condition, it can be debilitating because of the discomfort of prolapsing tissue both internally and externally, associated drainage of mucus or blood, and the common occurrence of concomitant symptoms of fecal incontinence, constipation, or both, ⁽²⁾.