Rectal prolapse

Question 1

What is a rectal prolapse?

Answer 1

Protrusion of mucosal or full thickness layer of rectal tissue out of the anus

Question 2

What are the two types of rectal prolapse?

Answer 2

Partial or full thickness

Question 3

What is a partial thickness rectal prolapse?

Answer 3

rectal mucosa protrudes out of the anus

Question 4

What is a full thickness rectal prolapse?

Answer 4

The rectal wall protrudes out of the anus

Question 5

What causes a full thickness prolapse?

Answer 5

form of sliding hernia through a defect of fascia of the pelvic region, so due to chronic straining secondary to constipation, chronic cough or from multiple vaginal deliveries

Question 6

What causes a partial thickness prolapse?

Answer 6

loosening and stretching of the connective tissue that attaches the rectal mucosa to the remainder of the rectal wall, this is in conjunction with long standing haemorrhoids disease

Question 7

What are the risk factors for rectal prolapse?

Answer 7

increasing age, female, multiple deliveries, straining, anorexia, previous traumatic vaginal delivery

Question 8

What are the clinical features of rectal prolapse?

Answer 8

rectal mucus discharge, faecal incontinence, per rectum bleeding or visible ulceration, rectal fullness, tenesmus or repeated defecation

Question 9

What are the signs of rectal prolapse on examination?

Answer 9

may not be evident but if you get the patient to strain should see, DRE will have weakened anal sphincter,

Question 10

How can you diagnose an internal prolapse?

Answer 10

Defecating proctography and investigation under GA

Question 11

What is the management for a rectal prolapse?

Answer 11

increase dietary fibre and fluid intake, perineal or abdominal approach to surgery