Rectal prolapse involves the movement of a portion of rectum out through the anus. It can involve either full thickness of the rectal wall or just the lining (mucosal prolapse). This is often confused with hemorrhoids, which are venous structures within the anal canal. If these become enlarged, these structures can also prolapse out through the anus. Rectal prolapse is often caused by a weakening of the muscles of the pelvic floor and ligaments that support the rectum and attach it to the bones in the pelvis.
Although anyone can be affected, it tends to affect older individuals, those who have had hysterectomy or multiple childbirths or those with chronic constipation or neurologic disorders.
Diagnosis is often confirmed by a simple office visit and examination. There are varying degrees of rectal prolapse. The diagnosis must investigate the presence of other prolapsed organs (such as bladder or uterus), as this has the potential to influence treatment strategy. Often, this is done with a radiology evaluation and an examination of the inside of the rectum with a scope to determine if a cause for the prolapse is evident.
Treatment of rectal prolapse, especially a large one, is often surgical. It involves either fixation of the rectum to prevent ongoing prolapse or removal of a segment of the rectum that is redundant. Often, this also includes placement of a piece of plastic mesh to aid in the fixation. There are many different surgical approaches to treating this problem and only your doctor can decide which is best for you. Recurrence may occur after surgical treatment. Additionally, alteration in bowel function may occur, such as the development of constipation or incontinence. The ultimate result is often difficult to predict prior to surgery. Surgery is the only way to cure significant rectal prolapse.
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