Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies.

Published

Journal Article (Review)

Rectal prolapse can present in a variety of forms and is associated with a range of symptoms including pain, incomplete evacuation, bloody and/or mucous rectal discharge, and fecal incontinence or constipation. Complete external rectal prolapse is characterized by a circumferential, full-thickness protrusion of the rectum through the anus, which may be intermittent or may be incarcerated and poses a risk of strangulation. There are multiple surgical options to treat rectal prolapse, and thus care should be taken to understand each patient's symptoms, bowel habits, anatomy, and pre-operative expectations. Preoperative workup includes physical exam, colonoscopy, anoscopy, and, in some patients, anal manometry and defecography. With this information, a tailored surgical approach (abdominal versus perineal, minimally invasive versus open) and technique (posterior versus ventral rectopexy +/- sigmoidectomy, for example) can then be chosen. We propose an algorithm based on available outcomes data in the literature, an understanding of anorectal physiology, and expert opinion that can serve as a guide to determining the rectal prolapse operation that will achieve the best possible postoperative outcomes for individual patients.

Full Text

Duke Authors

Cited Authors

  • Bordeianou, L; Hicks, CW; Kaiser, AM; Alavi, K; Sudan, R; Wise, PE

Published Date

  • May 2014

Published In

Volume / Issue

  • 18 / 5

Start / End Page

  • 1059 - 1069

PubMed ID

  • 24352613

Pubmed Central ID

  • 24352613

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-013-2427-7

Language

  • eng

Conference Location

  • United States