Abstract
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are
most commonly prolapse of the rectum and pain with bowel movements or straining, with
worsening fecal incontinence over time due to progressive stretching of the anal sphincters.
Physical findings are fairly consistent from patient to patient—most notably diastasis
of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile
mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical
exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic
floor dysfunction. Multiple surgical repairs are available, but treatment must be
individualized based on patient symptoms and the presence or absence of constipation
or other pelvic floor disorders. Mesh repairs have shown promising results, but carry
the added risks of mesh erosion, infection, and mesh migration. The optimal repair
has not been clearly demonstrated at this time.
Keywords
rectal prolapse - rectopexy - mesh repair - laparoscopy
