RECTAL PROLAPSE

A rectal prolapse occurs when the rectal wall turns inside out, falls and slides into the anus. It occurs initially during defecation and, in more advanced cases, during coughing, weight lifting or even spontaneously. This may cause ulcers, bleeding, or even wall necrosis. It occurs most often in children but also in the elderly, more often in women and is due to muscle deficiency of the pelvic floor (perineum).

Pediatric rectal prolapse is usually treated conservatively, with good results. Partial prolapse in adults is treated with injection sclerotherapy, mucosal excision and other techniques, while total prolapse is treated with a series of restoration surgical techniques.

Laparoscopic restoration is increasingly accepted at the approach of choice in the treatment of rectal relapse. It is recommended for retracting and fixing by sutures the rectal walls with or without using a mesh (rectopexy). Laparoscopic image prevails, especially at areas such as the middle and lower rectum. It appears that the laparoscopic approach is associated with lower morbidity, acceptable relapse rates and better results in functionality.