Rectal prolapse
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| ICD-10 | K62.3 |
|---|---|
| ICD-9 | 569.1 |
Rectal prolapse normally describes a medical condition wherein the walls of the rectum protrude through the anus and hence become visible outside the body. There are three chief conditions which come under the title rectal prolapse:
- Full-thickness rectal prolapse describes the entire rectum protruding through the anus
- Mucosal prolapse describes only the rectal mucosa (not the entire wall) prolapsing
- Internal intussusception wherein the rectum collapses but does not exit the rectum
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[edit] Causes
It is caused by weakness of the pelvic floor muscles and descending of the pelvic floor organs (uterus) - this is why the condition is most common among middle-aged to elderly women (women account for 85% of all reported conditions*). It is often accounted to chronic abdominal straining (notable in pregnancy, constipation) and anal sex.
Additionally, infection with whipworm can weaken these muscles and cause rectal prolapse in children.
[edit] Progression
The condition undergoes progression: beginning with prolapsation during bowel movements, through Valsalva movements (sneezing and so forth), then through daily activities such as walking until finally it may become chronic and ceases to retract.
[edit] Treatment
Pharmaceutically, the condition may only be treated secondarily (by treating deficate) so as to avoid further straining.
The alternative is surgery, it may be divided into two forms of procedure: abdominal surgery and perineal surgery.
- Abdominal surgery - for younger patients, but is more dangerous
- Anterior resection
- Marlex rectopexy
- Suture rectopexy
- Resection rectopexy
- Perineal surgery - often performed on older patients and is less dangerous
- Anal encirclement
- Delorme mucosal sleeve resection
- Altemeier perineal rectosigmoidectomy
- Hemorrhoidectomy
- Children are treated with linear cauterization
[edit] Notes
Due to the elderly nature of sufferers, the condition is generally under-reported.
