Approach to concomitant rectal and uterine prolapse: case report

Abstract

The classic description of rectal prolapse is a protrusion of the rectum beyond the anus. Peaks of occurrences are noted in the fourth and seventh decades of life, and most patients (80-90%) are women. The condition is often concurrent with pelvic floor descent and prolapse of other pelvic floor organs, such as the uterus or the bladder. In this study, two cases having contraindication to general anesthesia with rectal and uterine prolapse are presented. These cases were operated on under local anesthesia with support of sedation by Leforte and Delorme's operation at the same time. In conclusion; pelvic floor disorders should be considered as a whole, and surgical correction of rectal prolapse and uterine prolapse may be done at the same time under local anesthesia with the support of sedation. Performance of these operations by experienced and trained pelvic reconstructive surgeons may be advocated.

Rectal Prolapse Concomitant with Uterovaginal Prolapse Protects the Ileum from Necrosis in Transanal Ileum Evisceration through a Traumatic Tear on the Sigmoid Wall

“…Although the etiology of pelvic organ prolapse is multifactorial, vaginal delivery is known as the strongest risk factor by many epidemiological studies [11]. The pelvic floor disorders often develop as a result of a spontaneous unsupervised delivery [12] or repeated pregnancies and childbirths causing stretching and tearing of the endopelvic fascia, levator ani muscles, and perineal body [12,13]. The rarer cases are the connective tissue disorder, and Ehlers-Danlos syndrome is also associated with uterovaginal and/or rectal prolapse [14].…”

Concurrent occurrence of uterovaginal and rectal prolapse: An uncommon presentation

“…Concomitant existence of uterovaginal and rectal prolapse is a rare, but very distressing condition that poses a challenge to the gynecologist. [ 1 ] Isolated uterovaginal or rectal prolapse is more common and the treatment is not as challenging as in the existence of the two in the same patient. [ 1 ] The etiology of uterovaginal and/or rectal prolapse is multifactorial; pelvic floor disorders, connective tissue disorders, and genetic predispositions have been implicated.…”

“…[ 1 ] Isolated uterovaginal or rectal prolapse is more common and the treatment is not as challenging as in the existence of the two in the same patient. [ 1 ] The etiology of uterovaginal and/or rectal prolapse is multifactorial; pelvic floor disorders, connective tissue disorders, and genetic predispositions have been implicated. [ 1 2 ] The pelvic floor disorders often develop as a result of repeated pregnancies and childbirths causing stretching and tearing of the endopelvic fascia, levator ani muscles, and perineal body.…”

“…[ 1 ] The etiology of uterovaginal and/or rectal prolapse is multifactorial; pelvic floor disorders, connective tissue disorders, and genetic predispositions have been implicated. [ 1 2 ] The pelvic floor disorders often develop as a result of repeated pregnancies and childbirths causing stretching and tearing of the endopelvic fascia, levator ani muscles, and perineal body. [ 1 2 ] A connective tissue disorder, Ehlers–Danlos syndrome, characterized by skin hyper-extensibility, abnormal wound healing, and joint hypermobility, is commonly associated with uterovaginal and/or rectal prolapse.…”

“…The management of concurrent uterovaginal and rectal prolapse is determined by certain factors including patient's age, desire for preservation of coital and/or reproductive functions, general medical status, severity of the condition, and previous attempts at surgical correction, symptomatology and physical examination findings. [ 1 2 ] In a 6 months follow-up of 33 cases of uterovaginal prolapse after abdominal sacrohysteropexy, Moiety et al ., reported a success rate of 94%. [ 3 ] Successful outcome has also been recorded in other studies.…”