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Rectal prolapse repair - series

Normal anatomy:
Normal anatomy

The rectum is the final portion of the large intestine. It empties stool from the body through the anus. The rectum is anchored in position by ligaments. When these ligaments weaken, the rectum can move out of its normal position, downward, and pass through the anus. This is called rectal prolapse.



Indications:
Indications

Rectal prolapse may be partial, involving only the mucosa or complete, involving the entire wall of the rectum. Children with myelomeningocele and bladder exstrophy as well as children with cystic fibrosis are particularly at risk. Rarely it can be caused by acute diarrhea or straining while passing constipated stool.

Most cases of prolapse do not require surgical correction. Infant prolapse often disappears without intervention.

Rectal prolapse repair is advised for a continued rectal prolapse that does not clear up or is unresponsive to treatment of an underlying condition.



Procedure:
Procedure

General anesthesia is used and the patient is deep asleep and pain-free. The surgeon makes an incision near the base of the spinal column (coccyx), and identifies the pelvic floor (perineal) support structures. The lower rectum is sutured to the puborectalis muscle for support, while the upper part of the rectum is pulled up and sutured to the sacrum.



Aftercare:
Aftercare

The surgery is usually effective in repairing the prolapse. The long-term prognosis is excellent.

Usually only 1 or 2 days of hospitalization is all that is required. Expect complete recovery within 4 weeks.




Review Date: 7/5/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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