Cause, Diagnosis, and Treatment of Rectal Prolapse

Abstract

Rectal prolapse is a protrusion of the entire thickness of the rectal wall through the anal sphincter; it is an obstacle to social life, and is often accompanied by fecal incontinence. The causes are considered to be: (1) diastasis of levator ani, (2) abnormally deep cul-de-sac, (3) redundant sigmoid colon, (4) patulous anal sphincter, and (5) loss of horizontal position of the rectum and its sacral attachment. The diagnosis can be easily made by confirming the total circumferential cylindrical prolapse of the rectum transanally. Historically, various surgical procedures have been developed, and many institutions tend to employ the methods with which they are most proficient. In general, it is considered that the abdominal approach is more invasive and has fewer recurrences, but that the perineal approach is less invasive and has more recurrences. Considering that this disease is common in the elderly, when selecting the surgical method it is important to consider the patient's general health condition carefully, the preferences of both the patient and their family, and the curability. This paper provides an overview of the causes, diagnosis, and treatment of rectal prolapse.