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Rectal prolapse, prolapse, mucosal prolapse, mucohemorrhoidal prolapse, prolapsed hemorrhoids

Rectal prolapse and medical history

Rectal prolapse was one of the first anorectal pathological conditions to be studied; its first description, in the Ebers papyrus-a collection of medical prescriptions, magic formulas and various remedies datable to the 18th dynasty of Egypt-dates back to 1500 B.C., and in this work the author describes honey-based suppositories, laxatives and enemas as remedies for treating prolapse.

Defecatory strains, constipation (67% of patients) but also diarrhea (15%), andincontinence (70% of patients) are often associated with it. Other predisposing conditions may include pregnancy, benign prostatic hypertrophy, respiratory diseases associated with frequent and intense coughing, pelvic floor diseases, and parasitic infestations (amoebiasis, schistosomiasis).

It is much more common in women, who suffer from it more often after the age of 60, than in men, in whom it can occur at a much younger age, between 20 and 30; fortunately, surgery usually becomes necessary only in older patients.

complete rectal prolapse

Rectal prolapse: classification

Three main types of rectal prolapse are recognized:

1) il prolasso completo, nel quale la parete del retto in toto fuoriesce dall’orifizio anale;
2) il prolasso mucoso, in cui a fuoriuscire è solo la mucosa rettale; questo si verifica prevalentemente in presenza di emorroidi non trattate e di vecchia data;
3) l’intussuscezione interna, caratterizzata da un prolasso completo o mucoso che però non fuoriesce dall’ano.

Anal pain, rectal prolapse, mucosal prolapse, anal fissureIf left untreated, the rectal prolapse can lead, albeit rarely, to incarceration and strangulation of the prolapsed part, just as is the case with hernias. More frequently, the prolapse can give problems of bleeding, ulceration Of the prolapsed walls and incontinence.

What is the treatment of rectal prolapse?

The treatment of complete rectal prolapse, in adults, is exquisitely surgical. Surgical techniques are numerous, but can be essentially divided into two large families: those with an intraabdominal approach, in which the prolapse is treated by reaching the rectum with an incision of the wall of the abdomen or laparoscopically, and in which a resection of the colon is also often performed, when the latter is very long; and those perineal, in which the rectum is reached from the outside. The latter procedures are characterized by a higher recurrence rate, but are less aggressive than the surgical techniques mentioned earlier, and are generally reserved for older patients, while intraabdominal access is preferred in younger patients.

Mucosal prolapse, complete rectal prolapse, complete mucosal prolapse, mucohemorrhoidal prolapseThe treatment of the rectal prolapse mucous coincides with the treatment of the hemorrhoids generally associated with it. 

The coloproctology specialists from Cuccomarino, MD have extraordinarily perfected mucoriduction techniques for elastic ligation and fixation with sclerosis, so many of our patients, especially if they are elderly and have risk factors that might make traditional surgery problematic, are treated outpatient transanally by elastic ligation and sclerosis sessions, with excellent results, no need for anesthesia or inpatient stay, and immediate return to their usual occupations.


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