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Rectal Prolapse

Chapter

Abstract

Rectal prolapsed (or procidentia) is a protrusion of a full-thickness portion of the rectum through the anal sphincter, usually associated with a long history of constipation and straining, and, in women, with other pelvic floor abnormalities. Although uncommon, rectal prolapse is more frequent in elderly women. The condition is related to a concentric intussusception of the rectum secondary to weakness of the surrounding structures and exacerbated by constipation. The symptoms reflect the degree of progression of the condition: in the early stage, the main complaint is bowel regulation and constipation; in later stage, a permanently extruded rectum becomes excoriated and ulcerated, along with incontinence, constipation, and impaired anorectal sensation. Multiple surgical procedures are utilized to treat this condition, either through a perineal or trans-abdominal approach, with the former approach adopted for elderly patients with multiple comorbidities. Operation indicated for healthy adults is abdominal rectopexy with or without sigmoidectomy. While the perineal procedures have a low morbidity and mortality rate, recurrence rate may be up to 22%. Abdominal operations, despite significant morbidity, provide a lower recurrence rate.

Keywords

Pelvic Floor Fecal Incontinence Bulimia Nervosa Rectal Prolapse Rectal Wall 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Colo-rectal Surgery, Department of SurgerySaint Peter’s University HospitalEast BrunswickUSA
  2. 2.Department of General SurgeryRobert Wood Johnson University Hospital/UMDNJNew BrunswickUSA

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