Rectal Prolapse

Abstract

Rectal prolapse is a telescoping of the rectum out of the anus.

Rectal intussusception is when the telescoping does not protrude through the anal canal.

Many patients have other associated pathologies of the pelvic floor.

Fecal incontinence is a common associated symptom.

There is also a frequent association with anterior compartment pathologies such as urinary incontinence, voiding disorders, cystocele, or rectocele.

Nearly 100 years ago, Moschcowitz suggested that rectal prolapse occurs as a sliding hernia through a defect within the pelvic fascia. Later, Broden and Snellman demonstrated, with the aid of cinedefecography, that rectal prolapse is an intussusception of the rectum.

Rectal prolapse is more common in women than in men and is associated with childbirth, prolonged straining at stool, and/or anatomical considerations such as a wider pelvis. In women, the disorder increases in frequency with age and associated with damage to the pudendal nerves during childbirth and/or chronic straining at stool.