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The Netherlands Journal of Surgery Dec 1989Rectal prolapse in children is nowadays a rare anomaly. Potty training in young children is the common cause and the resulting prolapse can be treated conservatively. In... (Review)
Review
Rectal prolapse in children is nowadays a rare anomaly. Potty training in young children is the common cause and the resulting prolapse can be treated conservatively. In children with refractory prolapse, sclerosing injections may be used. Operative treatment by posterior rectopexy is only indicated in the very few cases of long-standing prolapse.
Topics: Adolescent; Child; Child, Preschool; Defecation; Humans; Male; Radiography; Rectal Prolapse; Toilet Training
PubMed: 2694022
DOI: No ID Found -
ANZ Journal of Surgery Apr 2020
Topics: Humans; Rectal Prolapse
PubMed: 31081277
DOI: 10.1111/ans.15249 -
Clinics in Gastroenterology Oct 1986Rectal prolapse and solitary rectal ulcer syndrome are both benign conditions affecting the rectum, mainly in women; prolapse tends to occur late in life, while solitary... (Review)
Review
Rectal prolapse and solitary rectal ulcer syndrome are both benign conditions affecting the rectum, mainly in women; prolapse tends to occur late in life, while solitary rectal ulcer syndrome has a predilection for the younger adult. Complete rectal prolapse probably starts as a mid-rectal intussusception, although a combination of this theory and the 'sliding hernia' theory has been proposed by Altemeier et al (1971). The pelvic floor weakness associated with prolapse, which gives rise to incontinence, is most likely due to a traction injury to the pudendal nerve. Anorectal manometry will indicate those incontinent patients likely to benefit from rectopexy. Abnormal descent of the perineum may be found in rectal prolapse and solitary rectal ulcer syndrome as well as descending perineum syndrome per se. The clinical features of these three conditions can overlap. Solitary rectal ulcer syndrome is essentially due to prolapse and traumatization of the rectal mucosa. Inappropriate puborectalis contraction, abnormal perineal descent, and overt rectal prolapse have all been cited as possible mechanisms of development of the condition. Defecography is the radiologic investigation of choice. Electromyography, as in rectal prolapse, may show evidence of pudendal nerve damage although incontinence is rare.
Topics: Adult; Aged; Child; Female; Humans; Infant; Male; Middle Aged; Rectal Diseases; Rectal Prolapse; Ulcer
PubMed: 3536217
DOI: No ID Found -
The Medical Journal of Malaysia Jun 2011The management of irreducible rectal prolapse is controversial. Surgeons may attempt conservative management by application of sugar. When surgery becomes inevitable the... (Review)
Review
The management of irreducible rectal prolapse is controversial. Surgeons may attempt conservative management by application of sugar. When surgery becomes inevitable the choice of procedure varies. We reviewed eight cases and noted the clinical findings and the results of conservative and surgical management. In four cases sugar was applied first, and failed. Emergency surgery always gave good outcomes. The procedures included simple reduction, rectopexy, laparotomy with resection, Delorme's repair, and perineal resection. Our experience and review of the literature indicate that surgery should be performed early in irreducible prolapse. Perineal resection may be the most suitable emergency procedure.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Emergencies; Female; Humans; Male; Middle Aged; Rectal Prolapse; Treatment Outcome
PubMed: 22106687
DOI: No ID Found -
International Journal of Colorectal... Dec 2016Internal rectal prolapse is common and correlates with age. It causes a plug-like physical obstruction and is a major cause of defecation disorder. The progressive...
PURPOSE
Internal rectal prolapse is common and correlates with age. It causes a plug-like physical obstruction and is a major cause of defecation disorder. The progressive distortion of the prolapsing rectum likely causes secondary defects in the rectal wall, which may exacerbate rectal dysfunction. We undertook a prospective observational study to detect and quantify the neurologic and histopathologic changes in the rectal wall.
METHODS
We examined dorsal and ventral rectal wall specimens from consecutive patients with internal rectal prolapse undergoing stapled transanal rectal resection (STARR). We subjected specimens to histopathologic and neuropathologic assessment, including immunohistochemistry. We also recorded patients' clinical and demographic characteristics and sought correlations between these and the pathologic findings.
RESULTS
We examined 100 specimens. The severity of rectal prolapse and the extent of descent of the perineum correlated significantly with age. Concomitant hemorrhoidal prolapse was noted in all male patients and in 79 % of female patients. Muscular and neuronal defects were detected in 94 and 90 % of the specimens, respectively. Only four specimens (4 %) were free of significant structural defects.
CONCLUSION
Rectal prolapse traumatizes the rectum causing neuromuscular defects. The tissue trauma is due to shearing forces and ischemia caused by the intussusception. This initiates a self-reinforcing vicious circle of physical and functional obstruction, further impairing rectal evacuation and causing constipation and incontinence. The correlation between extent of prolapse and age suggests that internal rectal prolapse can be considered a degenerative disorder. Neural and motor defects in the wall of the rectum caused by rectal prolapse are likely irreversible.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Defecography; Female; Humans; Male; Middle Aged; Neuromuscular Junction; Rectal Prolapse; Rectum
PubMed: 27599704
DOI: 10.1007/s00384-016-2649-8 -
The Turkish Journal of Gastroenterology... Dec 2019
Topics: Humans; Rectal Prolapse
PubMed: 31258139
DOI: 10.5152/tjg.2019.19196 -
Polski Przeglad Chirurgiczny Aug 2013Rectal prolapse belongs to the group of rare diseases of the rectum and anus. It is mostly observed in elderly multiparous women in the seventh and eighth decade. The...
UNLABELLED
Rectal prolapse belongs to the group of rare diseases of the rectum and anus. It is mostly observed in elderly multiparous women in the seventh and eighth decade. The precise cause of this pathology is not thoroughly understood that is why there are no optimal standards of treatment. The aim of the study was to present pathophysiology, diagnostics and optimal surgical procedures employed in young patients with rectal prolapse.
MATERIAL AND METHODS
Out of a 56-patient group treated in Department of General and Colorectal Surgery in the years 2006-2011 a smaller one consisting of 11 young women between the ages 20-40 was selected. According to the literature this is a very rare time of the mentioned pathology occurrence. In the studied females grade of rectal prolapse as well as faecal incontinence based on Jorge-Wexner's (Cleveland) scale were assessed before and after the operative treatment. All of them underwent transabdominal Wells and Frikman-Goldberg prolapse procedures.
RESULTS
Transabdominal approaches repair pathologies of the pelvic floor and have promising longstanding results improving quality of life. No rectal prolapse recurrences were observed. The mean score of the Wexner's grading system was 7.81 diminishing to 1.9 points postoperatively.
CONCLUSIONS
Rectal prolapse if untreated, is a pathology that substantially changes patients' quality of life for the worse. Individual, standardized surgical approach to each patient is necessary. Transabdominal methods carry a low risk of complications and improve quality of life of young patients enabling a relatively quick return to normal life.
Topics: Adult; Chronic Disease; Constipation; Fecal Incontinence; Female; Follow-Up Studies; Humans; Length of Stay; Pelvic Floor; Quality of Life; Rectal Prolapse; Recurrence; Treatment Outcome; Young Adult
PubMed: 24009054
DOI: 10.2478/pjs-2013-0067 -
The Pan African Medical Journal 2016Rectal prolapse is a rectal static disorder which involves rectal wall intussusception inducing its externalization through the anus. It usually affects children and the... (Review)
Review
Rectal prolapse is a rectal static disorder which involves rectal wall intussusception inducing its externalization through the anus. It usually affects children and the elderly. Its occurrence in young adults is rare. Strangulated rectal prolapse is also a rare complication. We report the case of a 30-year old patient who underwent emergency surgery for strangulated rectal prolapse. Emergency perineal rectosigmoidectomy (Altemeier repair) was performed with simple outcome.
Topics: Adult; Age Factors; Digestive System Surgical Procedures; Emergencies; Humans; Male; Rectal Prolapse; Treatment Outcome
PubMed: 28250884
DOI: 10.11604/pamj.2016.25.60.10721 -
The British Journal of Surgery Jul 1997Rectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal... (Review)
Review
BACKGROUND
Rectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal prolapse remains highly controversial, but it is recognized that associated functional problems, such as incontinence and constipation, are common. The pathophysiology, and controversies surrounding continence and constipation, remain topics of debate.
METHOD
All relevant papers derived from Medline and manual searching on rectal prolapse and associated functional problems were reviewed.
RESULTS AND CONCLUSION
The surgical management of rectal prolapse has evolved from historical encirclement procedures to current minimally invasive ones. Successful management must include adequate attention to the associated functional problems in order to eradicate the basic abnormality.
Topics: Adult; Constipation; Fecal Incontinence; Humans; Laparoscopy; Rectal Prolapse; Recurrence
PubMed: 9240128
DOI: 10.1002/bjs.1800840705 -
Journal of Pediatric Gastroenterology... Dec 2020
Topics: Digestive System Surgical Procedures; Humans; Polyps; Rectal Prolapse; Rectum; Recurrence; Treatment Outcome
PubMed: 33215896
DOI: 10.1097/MPG.0000000000002830