Key Concepts

• Full-thickness rectal prolapse can present with many symptoms including rectal/pelvic pressure, bowel habit irregularity, incomplete evacuation of stool with defecation, seepage of mucous, occasional blood on stool or toilet paper, fecal urgency, and outlet dysfunction constipation. Additionally questions directed at symptoms from the middle and anterior compartments should be asked to plan treatment. A multidisciplinary approach can enhance the outcomes.
• Testing is done to gain insight into the strength, coordination, and anatomic pelvic deficits associated with the prolapse.
• Treatment is nearly always surgical with over 100 procedures reported to treat rectal prolapse. The approach is either perineal or abdominal.
• Ventral mesh rectopexy facilitated by a laparoscopic or robotic approach has rapidly gained acceptance as a favored surgical therapy for rectal prolapse.