Treatment of internal rectal prolapse by rectopexy

Abstract

Internal rectal prolapse (IRP), also known as rectoanal intussusception, occult rectal prolapse or incomplete rectal prolapse, may be described as a full-thickness circumferential infolding arising from the midrectum during straining at defecation and which does not extend beyond the anal canal. However, a consensus clinical definition is lacking, and this makes interpretation of the surgical literature confusing. Most reports are single-unit studies with small numbers accrued over relatively long time periods. A number of procedures have been performed using inconsistent patient selection criteria, and there are no randomised trials. Many authors emphasise conservative therapy as the first line of management in most patients, but we feel that there are good indications for surgery in certain patients: the key is in careful patient selection. What follows is an account of the published results of surgery for IRP, concluding with our own approach to patient selection and operative technique. © 2008 Springer-Verlag Italia.