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Clin Colon Rectal Surg 2017; 30(01): 057-062
DOI: 10.1055/s-0036-1593426
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Abdominal Approaches to Rectal Prolapse

Kyla Joubert
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Jonathan A. Laryea
1   Division of Colon and Rectal Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
› Author Affiliations
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Publication History

Publication Date:
22 December 2016 (online)

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Abstract

Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient—most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction. Multiple surgical repairs are available, but treatment must be individualized based on patient symptoms and the presence or absence of constipation or other pelvic floor disorders. Mesh repairs have shown promising results, but carry the added risks of mesh erosion, infection, and mesh migration. The optimal repair has not been clearly demonstrated at this time.

Keywords

rectal prolapse - rectopexy - mesh repair - laparoscopy
 

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