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Rectal prolapse and rectal invagination

R Farouk1, G S Duthie

  • 1Academic Surgical Unit, Castle Hill Hospital, University of Hull, East Yorkshire, England.

The European Journal of Surgery = Acta Chirurgica
|July 17, 1998
PubMed
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Chronic straining can cause solitary rectal ulcers, internal rectal intussusception, and rectal prolapse. Pelvic floor muscle training, diet, and fiber are primary treatments, with surgery reserved for persistent cases.

Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Pelvic floor dysfunction

Background:

  • Solitary rectal ulcer, internal rectal intussusception, and complete rectal prolapse are defaecatory disorders potentially linked by chronic straining.
  • Pelvic floor weakness can exacerbate prolapse with fecal incontinence.
  • Understanding these conditions is challenging due to small patient numbers, limited trials, and conflicting anorectal physiology data.

Purpose of the Study:

  • To outline the common etiology and treatment strategies for solitary rectal ulcer, internal rectal intussusception, and complete rectal prolapse.
  • To differentiate primary medical management from surgical interventions.
  • To identify diagnostic tools for surgical candidate selection.

Main Methods:

  • Literature review and clinical consensus on defaecatory disorders.

Related Experiment Videos

  • Analysis of treatment outcomes for medical and surgical interventions.
  • Evaluation of diagnostic modalities like defaecating proctography.

    • Main Results:

    • Non-surgical management (pelvic floor training, diet, fiber) is the first-line treatment for symptomatic internal intussusception or solitary rectal ulcer.
    • Surgery is indicated for medical treatment failures, offering symptom relief in over two-thirds of patients.
    • Defaecating proctography can help identify patients unlikely to benefit from surgery.
    • External prolapse primarily requires surgical intervention, with approach tailored to patient factors and surgical expertise.

    Conclusions:

    • Conservative management should be prioritized for specific defaecatory disorders.
    • Surgical intervention is effective for refractory cases and external prolapse.
    • Personalized treatment strategies, considering patient condition and diagnostic assessments, are crucial for optimal outcomes.