Pathophysiology of rectal prolapse Introduction Rectal prolapse; otherwise indicated as “complete prolapse” or “first-degree” prolapse, can be defined as a circumferential, full-thickness intussusception of the rectal wall with protrusion beyond the anal canal.1 The rectum, being the very last part of the gastro-intestinal tract just before the anus, detaches from the body. The rectum turns ‘inside out’ and telescopes through the anus.2 The definition emphasizes two important points: firstly, that rectal prolapse is the expression of a full-thickness intussusception, and secondly; protrusion of the rectum is outside the anus.1 While this could be very uncomfortable, it rarely results in an emergent medical problem. Though, it has a significant negative impact on a patient’s quality of life.2 Fig 1 – diagram showing progressive prolapse of rectum until it has protruded completely outside of the body.2 Pathophysiology The pathophysiological mechanism of rectal prolapse is not completely understood or agreed upon.3 It is likely the result of a multifactorial aetiology, and any single standard theory will be imprecise.1 However, two main theories regarding the pathophysiology of rectal …show more content…
In this instance, specific focus and attention is necessary to be drawn to the perineum. The perineum is the part of the trunk that lies caudal to the pelvic floor.1 The perineum contains the perineal body (also known as the central perineal tendon) and the deep and superficial transverse perineal muscles. The perineal body is the site along which the tendineus fibres from the two sides of the perineal muscles decussate each other across the midline. This muscle arrangement allows simultaneous contraction of the perineal muscles, which allow the perineal muscles to stretch and elevate as