Rectal prolapse

Rectal prolapse. It is evident to the naked eye and easy to diagnose, but it involves serious functional complications that considerably decrease the quality of life of patients.

Summary

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  • 1 Symptoms
  • 2 Classification
  • 3 Epidemiology
  • 4 Predisposing factors
  • 5 Clinical manifestations
  • 6 Diagnosis
  • 7 Complications
  • 8 Treatment
  • 9 Sources

Symptoms

It progressively leads to fecal incontinence, pelvic pain, continuous rectal tenesmus, bowel movements, fresh rectal bleeding, and continuous mucous discharge.

Classification

  1. Incomplete Rectal Prolapse: Only involves rectal mucosa without the other layers of the rectum wall. B.Complete Rectal Prolapse: Involves all layers of the rectal wall. BI Occult Prolapse or Intussusception. B.II. Protrusion of the rectum through the anus when pushing. B.III. Visible External Rectal Prolapse.

epidemiology

It predominates in elderly women older than 65 years and associated with multiparity.

Predisposing factors

Senile dementia , straining while defecating, parasitic infections such as schistosomiasis, whipworms, and amebiasis , neurological diseases such as Spina Bifida , multiparity, hysterectomy, long-standing constipation, and sigmoid hypermotility.

Clinical manifestations

Prolapse produces the sensation of a mass that protrudes through the rectum during defecation, as the disease progresses, the effort to prolapse the rectum increases as it happens when coughing, sneezing, and even climbing stairs.

As the mucosa is exposed to the environment, it presents ulcerations with which it produces bleeding, inflammation and mucus secretion. The skin around the prolapse macerates, dries out, causing itching or intense itching. There is a feeling of incomplete evacuation, straining when defecating and tenesmus. Most of the patients present with fecal incontinence and in a lower percentage constipation .

Diagnosis

The simple physical examination to make the prolapse evident by asking the patient to push is sufficient, however it is important to perform a rectosigmoidoscopy to look for a rectal ulcer would request. It is convenient to perform a colonoscopy and a colon by enema to determine the presence of colon cancer and to plan treatment.

Complications

  • Constipation
  • Other complications of the disease that caused the prolapse

Treatment

Surgical treatment for rectal prolapse

The treatment is eminently surgical, there are many alternatives that depend on the age and general conditions of the patient, the presence of constipation, the diameter of the sigmoid colon, and the expectations of each patient. There are two forms of surgery for rectal prolapse, some are abdominal procedures and others are perineal procedures.

 

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