eMedicine Specialties > Emergency Medicine > Gastrointestinal

Rectal Prolapse: Follow-up

Author: Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Contributor Information and Disclosures

Updated: Nov 5, 2009

Follow-up

Further Inpatient Care

  • Emergent rectosigmoidectomy is required if the prolapsed tissue is incarcerated and found to be nonviable.
  • Rupture of the rectum also constitutes a surgical emergency.
  • Obtain a prompt surgical evaluation if anal incontinence is present.

Further Outpatient Care

  • Arrange surgical follow-up care for further evaluation and definitive treatment of uncomplicated rectal prolapse.
  • Laparoscopic surgical rectopexy procedures have been developed that have outcomes as good as those for open procedures but with shorter hospital stays and better patient comfort.3,4

Complications

  • Mucosal ulceration
  • Necrosis of rectal wall
  • Postoperative mortality is low, but recurrence rate can be as high as 15%, regardless of operative procedure.
  • The most common postoperative complications involve bleeding and dehiscence at the anastomosis.

Prognosis

  • Spontaneous resolution usually occurs in children.
  • The prognosis generally is good with appropriate treatment.
  • Of patients with rectal prolapse who are aged 9 months to 3 years, 90% will need only conservative treatment.

Patient Education

Miscellaneous

Special Concerns

  • Pediatric patients
    • Rectal prolapse in children is usually a benign condition that needs evaluation for the underlying condition.
    • Childhood prolapse is most common in children younger than 3 years; mucosal prolapse is more common than complete prolapse (possibly because of poor fixation of the submucosa to the mucosa in pediatric patients).
    • Evaluate pediatric patients for cystic fibrosis; a significant percentage is affected with this disorder.
    • In contrast to adults, children usually can be treated nonsurgically and by managing the underlying condition.
 


More on Rectal Prolapse

Overview: Rectal Prolapse
Differential Diagnoses & Workup: Rectal Prolapse
Treatment & Medication: Rectal Prolapse
Follow-up: Rectal Prolapse
Multimedia: Rectal Prolapse
References
[ CLOSE WINDOW ]

References

  1. Gourgiotis S, Baratsis S. Rectal prolapse. Int J Colorectal Dis. Mar 2007;22(3):231-43. [Medline].

  2. Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94(3):207-10. [Medline].

  3. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. Jan 2005;140(1):63-73. [Medline].

  4. Marderstein EL, Delaney CP. Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol. Oct 2007;4(10):552-61. [Medline].

  5. Abcarian H. Prolapse and procidentia. In: Zuidema GD, ed. Shackelford's Surgery of the Alimentary Tract. 4th ed. WB Saunders Co; 1996:368-85.

  6. Bartolo DC. Rectal prolapse. Br J Surg. Jan 1996;83(1):3-5. [Medline].

  7. Boccasanta P, Rosati R, Venturi M, Montorsi M, Cioffi U, De Simone M, et al. Comparison of laparoscopic rectopexy with open technique in the treatment of complete rectal prolapse: clinical and functional results. Surg Laparosc Endosc. Dec 1998;8(6):460-5. [Medline].

  8. Coburn WM 3rd, Russell MA, Hofstetter WL. Sucrose as an aid to manual reduction of incarcerated rectal prolapse. Ann Emerg Med. Sep 1997;30(3):347-9. [Medline].

  9. Demirbas S, Ogün I, Celenk T, Akin ML, Erenoglu C, Yldz M. Early outcomes of laparoscopic procedures performed on military personnel with total rectal prolapse and follow-up. Surg Laparosc Endosc Percutan Tech. Aug 2004;14(4):194-200. [Medline].

  10. Fengler SA, Pearl RK, Prasad ML, Orsay CP, Cintron JR, Hambrick E, et al. Management of recurrent rectal prolapse. Dis Colon Rectum. Jul 1997;40(7):832-4. [Medline].

  11. Heine JA, Wong WD. Rectal prolapse. In: Mazier WP, ed. Surgery of the Colon, Rectum, and Anus. Harcourt Brace & Co; 1995:515-33.

  12. Hull TL, Milsom JW. Pelvic floor disorders. Surg Clin North Am. Dec 1994;74(6):1399-413. [Medline].

  13. Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am. Feb 1997;77(1):49-70. [Medline].

  14. Siafakas C, Vottler TP, Andersen JM. Rectal prolapse in pediatrics. Clin Pediatr (Phila). Feb 1999;38(2):63-72. [Medline].

  15. Williams JG, Madoff RD. Perineal repair for rectal prolapse. In: Problems in General Surgery. Vol 9. 1992:732-8.

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

rectal prolapse, rectal prolapse symptoms, rectal prolapse causes, rectal prolapse treatment, constipation, rectal pain, rectal bleeding, rectal ulceration, prolapsed rectum, fecal incontinence

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Lynn K Flowers, MD, MHA, FACEP, Physician Partner, ApolloMD, Atlanta, Georgia
Lynn K Flowers, MD, MHA, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Michael S Beeson, MD, MBA, FACEP, Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Summa Health System
Michael S Beeson, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, National Association of EMS Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eugene Hardin, MD, FAAEM, FACEP, Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.