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Rectal Prolapse

  • Gwanchul Lee
Chapter

Abstract

There are two hypotheses about the occurrence of the disease: sliding hernia and rectal intussusceptions. There are some cases accompanied by not only the prolapse of the rectum but also the urinary incontinence or protrusion of other pelvic organs. Defecography not only can be helpful in the early diagnosis of rectal prolapse but also can provide much information about the accompanied abnormal findings. Conservative treatment rarely cures, and the only method for a complete cure is surgery. When selecting the operation method, anatomical abnormalities and cause, patient’s general condition, and defecation disorder like fecal incontinence or constipation should be considered. For the operation methods, we have the transanal approach including Delorme or Altemeier’s operation and transabdominal approach such as resection rectopexy or rectopexy, and it is important to have a surgeon who is capable of both approaches.

Keywords

Rectal prolapse Rectal intussusception Delorme’s operation Altemeier’s operation 

References

  1. 1.
    Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6. Pubmed Central PMCID: 2918416.CrossRefGoogle Scholar
  2. 2.
    Harmston C, Jones OM, Cunningham C, Lindsey I. The relationship between internal rectal prolapse and internal anal sphincter function. Colorectal Dis. 2011;13(7):791–5.CrossRefGoogle Scholar
  3. 3.
    Bordeianou L, Lee KY, Rockwood T, Baxter NN, Lowry A, Mellgren A, et al. Anal resting pressures at manometry correlate with the Fecal Incontinence Severity Index and with presence of sphincter defects on ultrasound. Dis Colon Rectum. 2008;51(7):1010–4.CrossRefGoogle Scholar
  4. 4.
    Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. J Gastrointest Surg. 2014;18(5):1059–69.CrossRefGoogle Scholar
  5. 5.
    Felt-Bersma RJ, Tiersma ES, Cuesta MA. Rectal prolapse, rectal intussusception, rectocele, solitary rectal ulcer syndrome, and enterocele. Gastroenterol Clin N Am. 2008;37(3):645–68, ix.CrossRefGoogle Scholar
  6. 6.
    Dvorkin LS, Gladman MA, Epstein J, Scott SM, Williams NS, Lunniss PJ. Rectal intussusception in symptomatic patients is different from that in asymptomatic volunteers. Br J Surg. 2005;92(7):866–72.CrossRefGoogle Scholar
  7. 7.
    Gourgiotis S, Baratsis S. Rectal prolapse. Int J Color Dis. 2007;22(3):231–43.CrossRefGoogle Scholar
  8. 8.
    Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94(3):207–10.CrossRefGoogle Scholar
  9. 9.
    Broden B, Snellman B. Procidentia of the rectum studied with cineradiography. A contribution to the discussion of causative mechanism. Dis Colon Rectum. 1968;11(5):330–47.CrossRefGoogle Scholar
  10. 10.
    Kaufman HS, Buller JL, Thompson JR, Pannu HK, DeMeester SL, Genadry RR, et al. Dynamic pelvic magnetic resonance imaging and cystocolpoproctography alter surgical management of pelvic floor disorders. Dis Colon Rectum. 2001;44(11):1575–83; discussion 83–4. PubMed PMID: 11711726.CrossRefGoogle Scholar
  11. 11.
    Myers JO, Rothenberger DA. Sugar in the reduction of incarcerated prolapsed bowel. Report of two cases. Dis Colon Rectum. 1991;34(5):416–8.CrossRefGoogle Scholar
  12. 12.
    Sun WM, Read NW, Donnelly TC, Bannister JJ, Shorthouse AJ. A common pathophysiology for full thickness rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer. Br J Surg. 1989;76(3):290–5.CrossRefGoogle Scholar
  13. 13.
    Wallenhorst T, Bouguen G, Brochard C, Cunin D, Desfourneaux V, Ropert A, Bretagne JF, Siproudhis L. Long-term impact of full-thickness rectal prolapse treatment on fecal incontinence. Surgery. 2015;158(1):104–11.CrossRefGoogle Scholar
  14. 14.
    Cunin D, Siproudhis L, Desfourneaux V, Berkelmans I, Meunier B, Bretagne JF, Bouguen G. No surgery for full-thickness rectal prolapse: what happens with continence? World J Surg. 2013;37(6):1297–302.CrossRefGoogle Scholar
  15. 15.
    Lindsey I. Commentary: Best practice in rectal prolapse. Colorectal Dis. 2010;12(6):512–4.CrossRefGoogle Scholar
  16. 16.
    Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years’ experience with the one-stage perineal repair of rectal prolapse. Ann Surg. 1971;173(6):993–1006.CrossRefGoogle Scholar
  17. 17.
    Moschcowitz AV. The pathogenesis, anatomy and cure of prolapse of the rectum. Surg Gynecol Obstet. 1912;15:7–21.Google Scholar
  18. 18.
    Glasgow SC, Birnbaum EH, Kodner IJ, Fleshman JW, Dietz DW. Preoperative anal manometry predicts continence after perineal proctectomy for rectal prolapse. Dis Colon Rectum. 2006;49(7):1052–8.CrossRefGoogle Scholar
  19. 19.
    Snooks SJ, Henry MM, Swash M. Anorectal incontinence and rectal prolapse: differential assessment of the innervation to puborectalis and external anal sphincter muscles. Gut. 1985;26(5):470–6.CrossRefGoogle Scholar
  20. 20.
    Hawkins AT, Olariu AG, Savitt LR, Gingipally S, Wakamatsu MM, Pulliam S, Weinstein MM, Bordeianou L. Impact of rising grades of internal rectal intussusception on fecal continence and symptoms of constipation. Dis Colon Rectum. 2016;59(1):54–61.CrossRefGoogle Scholar
  21. 21.
    Lieberth M, Kondylis LA, Reilly JC, Kondylis PD. The Delorme repair for full-thickness rectal prolapse: a retrospective review. Am J Surg. 2009;197(3):418–23.CrossRefGoogle Scholar
  22. 22.
    Senapati A, Nicholls RJ, Thomson JP, Phillips RK. Results of Delorme’s procedure for rectal prolapse. Dis Colon Rectum. 1994;37(5):456–60.CrossRefGoogle Scholar
  23. 23.
    Watkins BP, Landercasper J, Belzer GE, Rechner P, Knudson R, Bintz M, Lambert P. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg. 2003;138(5):498–502.CrossRefGoogle Scholar
  24. 24.
    Schultz I, Mellgren A, Dolk A, Johansson C, Holmström B. Long-term results and functional outcome after Ripstein rectopexy. Dis Colon Rectum. 2000;43(1):35–43.CrossRefGoogle Scholar
  25. 25.
    Altman D, Zetterstrom J, Schultz I, Nordenstam J, Hjern F, Lopez A, Mellgren A. Pelvic organ prolapse and urinary incontinence in women with surgically managed rectal prolapse: a population-based case-control study. Dis Colon Rectum. 2006;49(1):28–35.CrossRefGoogle Scholar
  26. 26.
    Senapati A, Gray RG, Middleton LJ, Harding J, Hills RK, Armitage NC, Buckley L, Northover JM, PROSPER Collaborative Group. PROSPER: a randomised comparison of surgical treatments for rectal prolapse. Color Dis. 2013;15(7):858–68.CrossRefGoogle Scholar
  27. 27.
    Habr-Gama A, Jacob CE, Jorge JM, Seid VE, Marques CF, Mantese JC, Kiss DR, Gama-Rodrigues J. Rectal procidentia treatment by perineal rectosigmoidectomy combined with levator ani repair. Hepato-Gastroenterology. 2006;53(68):213–7.PubMedGoogle Scholar
  28. 28.
    Chun SW, Pikarsky AJ, You SY, Gervaz P, Efron J, Weiss E, Nogueras JJ, Wexner SD. Perineal rectosigmoidectomy for rectal prolapse: role of levatorplasty. Tech Coloproctol. 2004;8(1):3–8.CrossRefGoogle Scholar
  29. 29.
    Altomare DF, Binda G, Ganio E, De Nardi P, Giamundo P, Pescatori M. Rectal Prolapse Study Group. Long-term outcome of Altemeier’s procedure for rectal prolapse. Dis Colon Rectum. 2009;52(4):698–703.CrossRefGoogle Scholar
  30. 30.
    Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM. Comparison of perineal operations with abdominal operations for full-thickness rectal prolapse. World J Surg. 2010;34(5):1116–22.CrossRefGoogle Scholar
  31. 31.
    Khaikin M, Wexner SD. Treatment strategies in obstructed defecation and fecal incontinence. World J Gastroenterol. 2006;12(20):3168–73. Pubmed Central PMCID: 4087958.CrossRefGoogle Scholar
  32. 32.
    Bachoo P, Brazzelli M, Grant A. Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2000;(2):CD001758.Google Scholar
  33. 33.
    Tou S, Brown SR, Nelson RL. Surgery for complete (full-thickness) rectal prolapse in adults. Cochrane Database Syst Rev. 2015;(11):CD001758.Google Scholar
  34. 34.
    González-Argenté FX, Jain A, Nogueras JJ, Davila GW, Weiss EG, Wexner SD. Prevalence and severity of urinary incontinence and pelvic genital prolapse in females with anal incontinence or rectal prolapse. Dis Colon Rectum. 2001;44(7):920–6.CrossRefGoogle Scholar
  35. 35.
    Bordeianou L, Hicks CW, Olariu A, Savitt L, Pulliam SJ, Weinstein M, Rockwood T, Sylla P, Kuo J, Wakamatsu M. Effect of coexisting pelvic floor disorders on fecal incontinence quality of life scores: a prospective, survey-based study. Dis Colon Rectum. 2015;58(11):1091–7.CrossRefGoogle Scholar
  36. 36.
    Pescatori M, Spyrou M, Pulvirenti d’Urso A. A prospective evaluation of occult disorders in obstructed defecation using the ‘iceberg diagram’. Color Dis. 2006;8(9):785–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Gwanchul Lee
    • 1
  1. 1.Colorectal Division, Department of SurgeryHansol HospitalSeoulSouth Korea

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