Clinical Gastroenterology Vol.25 No.1(4-4)

Theme Current Topics Relating to the Anus
Title Benign Anal Disorders Rectal Prolapse
Publish Date 2010/01
Author Tetsuo Yamana Department of Proctology, Social Health Insurance Hospital
[ Summary ] Rectal prolapse is a common benign anorectal disorder. There is a much higher incidence of this condition in women than in men, and there is a particular correlation with age. Rectal intussusception is currently considered to be the primary etiology related to this condition, rather than sliding hernias. The typical symptoms are prolapse, mucous discharge, bleeding, fecal incontinence, and severe constipation. Diagnosis can be made by confirming prolapse on the examination table or on a toilet. Defecography is indicated ifassociated pelvic floor disorders need to be investigated. Surgical treatment is indicated in most cases to control prolapse. There are perineal and abdominal procedures available for treatment. The Gant-Miwa-Thiersch procedure is most frequently performed in Japan. Other common perineal procedures include the Délorme procedure and the Altemeier procedure. The PPH procedure and the ALTA procedure may be indicated if there is incomplete rectal prolapse or mucosal prolapse. Abdominal procedures can be performed with open or laparoscopic approaches. Optimal procedures should be selected based on the patient's condition. Concomitant pelvic organ prolapse in other regions can be surgically treated at the same time as the previously mentioned conditions.
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