Anal Prolapse and Rectal Prolapse
Anal prolapse is the prolapse of mucous membrane of the anal canal through the anus. Rectal prolapse is the prolapse of not only the mucous membrane but also all layers of the rectum through the anus. Here it is very important to differentiate between the two cases.
- The demarcation according to appearance of the prolapse can give us more information if this prolapse is anal or rectal.
- The anal prolapse, causes radial folding of mucous membrane but in case of rectal prolapse the foldings are circular.
- The symptoms are more or less in both cases similar with pain, incontinence, itching, irritation, swelling, bleeding and sometimes irreducible prolapse.
- The etiology of the anal prolapse is either because of advanced hemorrhoids between 3rd and 4th degree or anal sphincter weakness.
- With respect to the rectum prolapse either weakness of the sphincter muscles or weakness of he pelvic floor.
- Other causes of the rectum prolapse are for example, constipation, strong pressing, diarrhea.
- To diagnose the case, we need the history, clinical examination including pressing and rectal digital inspection, procto/rectoscopy, defecography, dynamic pelvic floor MRI and manometry by incontinence.
- The treatment is either conservative such as decongestant measures, anti-inflammatory systemic therapy, topical glucocorticoids, cooling, painkiller and manual reposition if necessary or operative treatment
- Surgery for anal prolapse is done usually by stapler hemorrhoidopexy or hemorrhoidectomy with anorectal repair.
- Surgery for rectum prolapse is usually done by rectopexy (with or without resection), STARR operation (Stapled Transanal Resection of the Rectum).
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