Skip to main content

Rectal Prolapse

  • Chapter
  • First Online:
Contemporary Coloproctology

Abstract

Rectal prolapse is a condition that has puzzled surgeons for many centuries. Ancient documents, including the Old Testament, give accurate descriptions of the condition. Surgical treatments for rectal prolapse emerged at the end of the nineteenth century, some of which have stood the test of time, although most remain historical curiosities. There is a voluminous literature on rectal prolapse, a PubMed search will identify nearly 3,000 articles focused on rectal prolapse. However, there is little level 1 evidence, with few properly powered randomized trials to provide a scientific evidence base to guide treatment [1]. This chapter on rectal prolapse gives an overview of current thinking on this condition while accepting that many questions remain unanswered.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tou S, Brown SR, Malik AI, Nelson RL. Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2008;(4):CD001758.

    Google Scholar 

  2. Pucciani F. Rectal prolapse: pathophysiology. In: Altomare DF, Pucciani F, editors. Rectal prolapse diagnosis and clinical management. Milan: Springer; 2008. p. 13–20.

    Chapter  Google Scholar 

  3. Marshman D, Percy J, Fielding I, Delbridge L. Rectal prolapse: relationship with joint mobility. Aust N Z J Surg. 1987;57:827–9.

    Article  PubMed  CAS  Google Scholar 

  4. Karulf RE, Madoff RD, Goldberg SM. Rectal prolapse. Curr Probl Surg. 2001;38:771–832.

    PubMed  CAS  Google Scholar 

  5. Madoff RD, Mellgren A. One hundred years of rectal prolapse surgery. Dis Colon Rectum. 1999;42:441–50.

    Article  PubMed  CAS  Google Scholar 

  6. Ripstein CB. A simple, effective operation for rectal prolapse. Postgrad Med. 1969;45:201–4.

    PubMed  CAS  Google Scholar 

  7. Gordon PH, Hoexter B. Complications of the Ripstein procedure. Dis Colon Rectum. 1978;21:277–80.

    Article  PubMed  CAS  Google Scholar 

  8. Roberts PL, Schoetz Jr D, Coller JA, Veidenheimer MC. Ripstein procedure. Lahey Clinic experience: 1963–1985. Arch Surg. 1988;123:554–7.

    Article  PubMed  CAS  Google Scholar 

  9. Morgan CN, Porter NH, Klugman DJ. Ivalon (polyvinyl alcohol) sponge in the repair of complete rectal prolapse. Br J Surg. 1972;59:841–6.

    Article  PubMed  CAS  Google Scholar 

  10. Novell JR, Osborne MJ, Winslet MC, Lewis AA. Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full-thickness rectal prolapse. Br J Surg. 1994;81:904–6.

    Article  PubMed  CAS  Google Scholar 

  11. Loygue J, Nordlinger B, Cunci O, et al. Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases. Dis Colon Rectum. 1984;27:356–9.

    Article  PubMed  CAS  Google Scholar 

  12. Portier G, Iovino F, Lazorthes F. Surgery for rectal prolapse: Orr-Loygue ventral rectopexy with limited dissection prevents postoperative-induced constipation without increasing recurrence. Dis Colon Rectum. 2006;49:1136–40.

    Article  PubMed  Google Scholar 

  13. D’Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc. 2006;20:1919–23.

    Article  PubMed  Google Scholar 

  14. Wijffels N, Cunningham C, Dixon A, et al. Laparoscopic anterior rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete? Colorectal Dis. 2011;13(5):561–6.

    Article  PubMed  CAS  Google Scholar 

  15. Speakman CT, Madden MV, Nicholls RJ, Kamm MA. Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomized study. Br J Surg. 1991;78:1431–3.

    Article  PubMed  CAS  Google Scholar 

  16. Frykman HM, Goldberg SM. The surgical treatment of rectal procidentia. Surg Gynecol Obstet. 1969;129:1225–30.

    PubMed  CAS  Google Scholar 

  17. Graf W, Karlbom U, Pahlman L, et al. Functional results after abdominal suture rectopexy for rectal prolapse or intussusception. Eur J Surg. 1996;162:905–11.

    PubMed  CAS  Google Scholar 

  18. Khanna AK, Misra MK, Kumar K. Simplified sutured sacral rectopexy for complete rectal prolapse in adults. Eur J Surg. 1996;162:143–6.

    PubMed  CAS  Google Scholar 

  19. Kessler H, Jerby BL, Milsom JW. Successful treatment of rectal prolapse by laparoscopic suture rectopexy. Surg Endosc. 1999;13:858–61.

    Article  PubMed  CAS  Google Scholar 

  20. Keighley MR, Fielding JW, Alexander-Williams J. Results of Marlex mesh abdominal rectopexy for rectal prolapse in 100 consecutive patients. Br J Surg. 1983;70:229–32.

    Article  PubMed  CAS  Google Scholar 

  21. Galili Y, Rabau M. Comparison of polyglycolic acid and polypropylene mesh for rectopexy in the treatment of rectal prolapse. Eur J Surg. 1997;163:445–8.

    PubMed  CAS  Google Scholar 

  22. Zittel TT, Manncke K, Haug S, et al. Functional results after laparoscopic rectopexy for rectal prolapse. J Gastrointest Surg. 2000;4:632–41.

    Article  PubMed  CAS  Google Scholar 

  23. Laubert T, Kleemann M, Schorcht A, et al. Laparoscopic resection rectopexy for rectal prolapse: a single-center study during 16 years. Surg Endosc. 2010;24:2401–6.

    Article  PubMed  Google Scholar 

  24. Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years’ experience with the one-stage perineal repair of rectal prolapse. Ann Surg. 1971;173:993–1006.

    Article  PubMed  CAS  Google Scholar 

  25. Chun SW, Pikarsky AJ, You SY, et al. Perineal rectosigmoidectomy for rectal prolapse: role of levatorplasty. Tech Coloproctol. 2004;8:3–9.

    Article  PubMed  CAS  Google Scholar 

  26. Porter N. Collective results of operations for rectal prolapse. Proc R Soc Med. 1962;55:1087–91.

    PubMed  CAS  Google Scholar 

  27. Prasad ML, Pearl RK, Abcarian H, et al. Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum. 1986;29:547–52.

    Article  PubMed  CAS  Google Scholar 

  28. Ramanujam PS, Venkatesh KS, Fietz MJ. Perineal excision of rectal procidentia in elderly high-risk patients. A ten year experience. Dis Colon Rectum. 1994;37:1027–30.

    Article  PubMed  CAS  Google Scholar 

  29. Gabriel WB. Prolapse of the rectum. In: Thomas CC, editor. Principles and practice of rectal surgery. 5th ed. Springfield: Charles C. Thomas; 1963. p. 165–217.

    Google Scholar 

  30. Finlay IG, Aitchison M. Perineal excision of the rectum for prolapse in the elderly. Br J Surg. 1991;78:687–9.

    Article  PubMed  CAS  Google Scholar 

  31. Williams JG, Rothenberger DA, Madoff RD, Goldberg SM. Treatment of rectal prolapse in the elderly by perineal rectosigmoidectomy. Dis Colon Rectum. 1992;35:830–4.

    Article  PubMed  CAS  Google Scholar 

  32. Kim DS, Tsang CB, Wong WD, et al. Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999;42:460–6.

    Article  PubMed  CAS  Google Scholar 

  33. Altomare DF, Binda G, Ganio E, et al. Long-term outcome of Altemeier’s procedure for rectal prolapse. Dis Colon Rectum. 2009;52:698–703.

    Article  PubMed  Google Scholar 

  34. Berman IR, Harris MS, Rabeler MB. Delorme’s transrectal excision for internal rectal prolapse. Patient selection, technique, and three-year follow-up. Dis Colon Rectum. 1990;33:573–80.

    Article  PubMed  CAS  Google Scholar 

  35. Gundersen AL, Cogbill TH, Landercasper J. Reappraisal of Delorme’s procedure for rectal prolapse. Dis Colon Rectum. 1985;28:721–4.

    Article  PubMed  CAS  Google Scholar 

  36. Houry S, Lechaux JP, Huguier M, Molkhou JM. Treatment of rectal prolapse by Delorme’s operation. Int J Colorectal Dis. 1987;2:149–52.

    Article  PubMed  CAS  Google Scholar 

  37. Monson JR, Jones NA, Vowden P, Brennan TG. Delorme’s operation: the first choice in complete rectal prolapse? Ann R Coll Surg Engl. 1986;68:143–6.

    PubMed  CAS  Google Scholar 

  38. Christiansen J, Kirkegaard P. Delorme’s operation for complete rectal prolapse. Br J Surg. 1981;68:537–8.

    Article  PubMed  CAS  Google Scholar 

  39. Abulafi AM, Sherman IW, Fiddian RV, Rothwell-Jackson RL. Delorme’s operation for rectal prolapse [see comments]. Ann R Coll Surg Engl. 1990;72:382–5.

    PubMed  CAS  Google Scholar 

  40. Oliver GC, Vachon D, Eisenstat TE, et al. Delorme’s procedure for complete rectal prolapse in severely debilitated patients. An analysis of 41 cases. Dis Colon Rectum. 1994;37:461–7.

    Article  PubMed  CAS  Google Scholar 

  41. Lechaux JP, Lechaux D, Perez M. Results of Delorme’s procedure for rectal prolapse. Advantages of a modified technique. Dis Colon Rectum. 1995;38:301–7.

    Article  PubMed  CAS  Google Scholar 

  42. Watts JD, Rothenberger DA, Buls JG, et al. The management of procidentia. 30 years’ experience. Dis Colon Rectum. 1985;28:96–102.

    Article  PubMed  CAS  Google Scholar 

  43. Watkins BP, Landercasper J, Belzer GE, et al. Long-term follow-up of the modified Delorme procedure for rectal prolapse. Arch Surg. 2003;138:498–502.

    Article  PubMed  Google Scholar 

  44. Lieberth M, Kondylis LA, Reilly JC, Kondylis PD. The Delorme repair for full-thickness rectal prolapse: a retrospective review. Am J Surg. 2009;197:418–23.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Graham Williams B.Sc., M.B.B.Ch., FRCS, M.Ch. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag London Limited

About this chapter

Cite this chapter

Williams, J.G. (2012). Rectal Prolapse. In: Brown, S., Hartley, J., Hill, J., Scott, N., Williams, J. (eds) Contemporary Coloproctology. Springer, London. https://doi.org/10.1007/978-0-85729-889-8_29

Download citation

  • DOI: https://doi.org/10.1007/978-0-85729-889-8_29

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-888-1

  • Online ISBN: 978-0-85729-889-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics