Rectal prolapse is commonly used to refer to complete rectal prolapse (external rectal prolapse), where the rectal wall prolapses to a certain extent, they protrude from the anus and are visible outside the body. However, most researchers believe that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed part is visible externally, and whether it involves all or only part of the thickness of the rectal wall.
Rectal prolapse may not have any symptoms, but depending on the nature of prolapse, there may be mucus discharge (mucus from the anus), rectal bleeding, degree of fecal incontinence, and obstructive defecation.
Rectal prolapse is usually more common in older women, although it can occur at any age and gender. It is rarely life-threatening, but if left untreated, these symptoms can be debilitating. Most cases of external prolapse can be successfully treated by surgery. Internal prolapse is traditionally difficult to treat and surgery may not be suitable for many patients.
Surgery is considered the only option to potentially cure complete rectal prolapse. Conservative measures may be beneficial for those medical problems that make them unsuitable for surgery and those with mild symptoms. Dietary adjustments, including increased dietary fiber, may help reduce constipation and thus reduce stress. Bulk forming agents (such as psyllium) or stool softeners can also reduce constipation.
Surgery is usually required to prevent further damage to the anal sphincter. The goal of surgery is to restore normal anatomy and minimize symptoms. Regarding which programs are more effective, there is no global consensus and more than 50 different operations are described.
The surgical method for rectal prolapse can be perineum or abdomen. The perineal approach (or through the perineum) refers to surgery through the anus and perineal incision (the area between the genitals and the anus) into the rectum and sigmoid colon. The abdominal approach (transabdominal approach) involves the surgeon cutting into the abdomen and gaining access to the pelvic cavity. Procedures for rectal prolapse may involve fixed bowel (rectal fixation), or resection, or both. The transfer of the inner rectum through the anus - anal surgery is also described.
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