Rectal prolapse is protrusion of rectal tissue through the anus to the exterior of the body. The rectum is the final section of the large intestine. Symptom severity will increase with the dimensions of the prolapse, and whether or not it spontaneously reduces once defecation, requires manual reduction by the patient, or becomes irreducible. The symptoms are similar to advanced hemorrhoidal sickness. Fecal discharge causing staining of undergarments, Rectal haemorrhage, mucous rectal discharge, Rectal pain, Pruritis ani.
The only potentially curative treatment for complete rectal prolapse is surgery, however in those patients with medical problems that make them unfit for surgery, and those patients who have minima symptoms conservative measures may benefit. Dietary adjustments, including increasing dietary fiber may be beneficial to reduce constipation,and thereby reduce straining. A bulk forming agent (e.g. psyllium) or stool softener can also reduce constipation. Biofeedback retraining may be indicated to help the patient avoid straining during defecation. There is limited evidence that hypopressive exercises may be beneficial in mild pelvic organ prolapse.
44(females 32) patients were identified with a mean age of 23 years old. 18 (41%) had chronic psychiatric diseases requiring treatment and these patients experienced significantly more constipation than non-psychiatric patients (83% vs. 50%; P = 0.024). 13(30%) patients had previous pelvic surgery. The most common symptom at presentation was a prolapsed rectum in 40 (91%) and hematochezia in 24 (55%). Twenty-four (55%) underwent a laparoscopic rectopexy, 14 (32%) open abdominal repair, and 6 (14%) had perineal surgery. The most common procedure was resection rectopexy in 21 (48%; 7 open; 14 laparoscopic). At a median follow-up of 11 (range 1–165) months, 6 patients (14%) developed a recurrence.