Rectal Prolapse, Rectal Intussusception, Rectocele, Solitary Rectal Ulcer Syndrome, and Enterocele
Section snippets
Definition, Etiology, and Pathogenesis
A complete rectal prolapse is defined as the protrusion of all layers of the rectal wall through the anal canal. If the rectal wall prolapses but does not protrude through the anus it is called an āoccult rectal prolapseā or a ārectal intussusception.ā A rectal prolapse should be distinguished from a mucosal prolapse; in the latter there is only protrusion of the rectal or anal mucosa. The incidence of rectal prolapse is approximately 2.5 per 100,000 inhabitants,1 with a highest incidence among
Definition, Etiology, and Pathogenesis
Rectal intussusception, occult rectal prolapse, or internal procidentia is an intussusception of the rectal wall that does not protrude through the anus and can be classified into high-grade (intrarectal) and low-grade (intra-anal) intussusception based on the level of mucosa protruding.47 Although it is associated with solitary rectal ulcer, rectal prolapse, or perineal descent, the finding per se is not pathologic. In 50% to 60% of healthy volunteers a rectal intussusception can be
Definition, Etiology, and Pathogenesis
SRUS was first described in 1830 by Cruveilhier, but was recognized as a clinical entity in 1969 by Madigan and Morson.65 The estimated annual incidence is 1 to 3.6 per 100,000.66 About 80% of patients are less than 50 years. Gender distribution is either equal or there is a slight female preponderance.66 The mean age of presentation is 49Ā years, and about 25% present after 60 years.67 The condition is associated with an evacuation disorder. Defecography has shown that an intussusception is
Definition, Etiology, and Pathogenesis
A rectocele is a protrusion of the anterior rectal wall usually toward the vagina. Weakness of the pelvic floor leads to a deficiency in the rectovaginal septum (the fascia of Denonvilliers, which is continuous with the perineal body) (Fig.Ā 7). Deficiency in the upper half of the septum produces a high rectocele, and that of the lower half a low rectocele. A rectocele can be classified as low, midvaginal, or high according to the new standardized terminology.85
Obstetric injury is the major
Definition, Cause, Pathogenesis
Enterocele is defined as a peritoneum-lined sac herniating down between the vagina and rectum filled with abdominal content, often the small bowel.113 It was first reported in 1932 and considered a rare clinical entity, until in 1973 after a larger series was presented114 the phenomena became more known in the gynecologic literature. With the increasing interest in dyssynergic defecation gastroenterologists and colorectal surgeons have focused more on pelvic floor abnormalities.115 The
References (117)
- et al.
Functional results after laparoscopic rectopexy for rectal prolapse
J Gambl Stud
(2000) - et al.
Prosthetic rectopexy to the pelvic floor and sigmoidectomy for rectal prolapse
Am J Surg
(2001) - et al.
Solitary rectal ulcer syndrome accompanied by submucosal invasive carcinoma
Am J Gastroenterol
(1998) - et al.
The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction
Am J Obstet Gynecol
(1996) - et al.
Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging
Urology
(1999) - et al.
Epidemiologic aspects of complete rectal prolapse
Scand J Surg
(2005) Rectal prolase and the solitary ulcer syndrome
(1994)- et al.
Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse
Br J Surg
(1981) - et al.
Risk factors in childbirth causing damage to the pelvic floor innervation
Int J Colorectal Dis
(1986) The pathogenesis, anatomy and cure of prolapseof the rectum
Surg Gynecol Obstet
(1912)