Rectal prolapse natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]

Overview

Hemorrhage occurs frequently if the prolapsed rectum is left unreduced. If rectal prolapse is persistent for a long time, urological impairments may be associated.
Common complications of rectal prolapse include fecal incontinence, constipation and rectal incarceration or even strangulation.
All women with prolapse can be treated and their symptoms improved, even if not completely resolved.

Natural History

Allowing rectal prolapse to continue untreated beyond 4 years may lead to higher rates of subsequent rectal prolapse recurrence, secondary to a weakened pelvic floor. ^[1] In addition, Hemorrhage occurs frequently if the prolapsed rectum is left unreduced. If rectal prolapse is persistent for a long time, urological impairments (bladder stones or urethral stricture) may be associated.^[2]

Complications

Common complications of rectal prolapse include:^[1]^[3]^[4]

Fecal incontinence (50-75%)
Constipation (25-50%)
Rectal incarceration or even strangulation

Prognosis

All women with prolapse can be treated and their symptoms improved, even if not completely resolved.^[5]

References

↑ ^1.0 ^1.1 Bordeianou L, Paquette I, Johnson E, Holubar SD, Gaertner W, Feingold DL, Steele SR (2017). “Clinical Practice Guidelines for the Treatment of Rectal Prolapse”. Dis. Colon Rectum. 60 (11): 1121–1131. doi:10.1097/DCR.0000000000000889. PMID 28991074.
↑ Shin EJ (2011). “Surgical treatment of rectal prolapse”. J Korean Soc Coloproctol. 27 (1): 5–12. doi:10.3393/jksc.2011.27.1.5. PMC 3053504. PMID 21431090.
↑ Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE (2014). “Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies”. J. Gastrointest. Surg. 18 (5): 1059–69. doi:10.1007/s11605-013-2427-7. PMID 24352613.
↑ Goldstein SD, Maxwell PJ (2011). “Rectal prolapse”. Clin Colon Rectal Surg. 24 (1): 39–45. doi:10.1055/s-0031-1272822. PMC 3140332. PMID 22379404.
↑ Weber AM, Richter HE (2005). “Pelvic organ prolapse”. Obstet Gynecol. 106 (3): 615–34. doi:10.1097/01.AOG.0000175832.13266.bb. PMID 16135597.

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[pmid28991074-1] 1.0 ^1.1 Bordeianou L, Paquette I, Johnson E, Holubar SD, Gaertner W, Feingold DL, Steele SR (2017). “Clinical Practice Guidelines for the Treatment of Rectal Prolapse”. Dis. Colon Rectum. 60 (11): 1121–1131. doi:10.1097/DCR.0000000000000889. PMID 28991074.

[pmid21431090-2] Shin EJ (2011). “Surgical treatment of rectal prolapse”. J Korean Soc Coloproctol. 27 (1): 5–12. doi:10.3393/jksc.2011.27.1.5. PMC 3053504. PMID 21431090.

[pmid24352613-3] Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE (2014). “Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies”. J. Gastrointest. Surg. 18 (5): 1059–69. doi:10.1007/s11605-013-2427-7. PMID 24352613.

[pmid22379404-4] Goldstein SD, Maxwell PJ (2011). “Rectal prolapse”. Clin Colon Rectal Surg. 24 (1): 39–45. doi:10.1055/s-0031-1272822. PMC 3140332. PMID 22379404.

[pmid16135597-5] Weber AM, Richter HE (2005). “Pelvic organ prolapse”. Obstet Gynecol. 106 (3): 615–34. doi:10.1097/01.AOG.0000175832.13266.bb. PMID 16135597.

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