[Utility of plug test during anoscopy for the ambulatory evaluation of rectal mucosal prolapse]

Rectal mucosal prolapse was characterized by the protrusion of the mucosa alone in the anal lumen. The Authors, to correctly establish the intraoperatory stage of rectal mucosal prolapse have performed a test based on the intrarectal introduction of a plug of great dimension, to successively pull-through the anal canal during anoscopy.

A total of 30 patients with proctological symptoms and with diagnosis of rectal mucosal prolapse has been submitted, in ambulatory setting, to a less invasive test with a small plug and in second time, using a plug entirely inserted in rectal lumen and to remove outside through the anus during anoscopy.

In all cases the plug test used during anoscopy permitted the perfect evaluation of the prolapse extension. In 12 patients the plug test evidenced a mucosal prolapse occupying the 25% of anal canal, in 10 patients the 50% of anal canal and in 8 patients a mucosal prolapse occupying up to the 50% of the anal circumference. The first 22 patients were treated transfixed stitch technique (TST) while for the other patients Longo surgical technique was preferred.

The plug test during anoscopy is efficacious to achieve differential diagnosis between rectal mucosal prolapse and haemorrhoidal prolapse. Indeed. it is useful to choice more precisely the type of surgical intervention.