Rectal Prolapse

Question 1

What two types of rectal prolapse are there?

Answer 1

Type 1: Mucosal prolapse

Type 2: Full thickness prolapse

Question 2

What type of patients are more likely to get Type 1 rectal prolapse?

Answer 2

Children, esp with CF

Question 3

What is the treatment for Type 1 rectal prolapse?

Answer 3

Essentially large piles, so treat the same

Con: Increase fibre, stop straining
Med: Lactulose, topical hydrocortisone+analgesia
Int: Banding, injecting sclerosant, cryo
Surg: Delorme’s procedure

But also, pelvic floor ex

Question 4

What group of patients tend to suffer from Type 2 rectal prolapse?

Answer 4

Elderly women with poor O+G Hx

Question 5

What Ix would you perform in rectal prolapse? (4)

Answer 5

Sigmoidoscopy to excluse proximal lesions
Anal manometry
Endoanal US
MRI