Rectal Prolapse

Question 1

What is a rectal prolapse. (2)

Answer 1

There are two types of rectal prolapse.

1. Full-thickness - a prolapse of all the layers of rectal wall through the anus. (this is known as type 2/complete).
2. Mucosal - a prolapse of the rectal mucosa through the anus. (this is known as type 1/partial).

Question 2

Who is most at risk of developing a rectal prolapse. (2)

Answer 2

The majority of patients who develop this problem are women. (usually multiparous).
Children less than 3 years old are also at risk.

Question 3

What are the symptoms of a rectal prolapse. (3)

Answer 3

Palpable mass.
Faecal incontinence.
PR bleeding.

Question 4

What are the signs of a rectal prolapse. (3)

Answer 4

Protruding rectal mass. (ask the patient to bear down).
Reduced sphincter tone in PR.
Evidence of ulceration.

Question 5

Is type 1 or type 2 rectal prolapse more common.

Answer 5

Type 2.

Question 6

What percentage of patients with rectal prolapse experience incontinence.

Answer 6

75%.

Question 7

What are the causes of rectal prolapse. (4)

Answer 7

Lax sphincter.
Prolonged straining.
Related to chronic neurological and psychological disorders.