Internal Rectal Prolapse: A Step-by-Step Approach to Assessment and Conservative or Surgical Therapy: A Review of the Literature |Biomedgrid

Background: Internal rectal prolapse is a rare pelvic floor disorder. Many anatomic and functional pelvic floor disorders may coexist. The assessment of this condition by a multidisciplinary team for pelvic floor disorders and further conservative measures are effective in most patients. Refractory symptoms may be treated by surgery. Material and Methods: A review of the literature based on Google Scholar and PubMed medical databases was performed. Parameters related to internal rectal prolapse as clinical ones, the associated functional and anatomical pelvic floor disorders coexisting with the internal rectal prolapse, the necessary preoperative examinations, and the final conservative or surgical treatment are reviewed. Cross-references of the published articles were used to accomplish this review study. Results: Physical examination of the perineum, patients' symptoms, history, the severity of symptoms, and many investigations need for the correct assessment of this condition; defecography, pelvic MRI, MR defecography, endorectal ultrasounds, anorectal manometry and electromyography of the pelvic floor muscles are the most common investigations. Most patients respond to conservative treatment. Refractory cases are treated by surgery; abdominal rectopexy procedures and perineal excisional mucosal techniques are the most common in use.