Intussusception of the rectum-internal procidentia

Abstract

A series of 90 patients with intussusception of the rectum (internal procidentia) has been studied. In 11 per cent of the patients there was also an enterocele and in 3 per cent, a large proctocele. Forty patients were operated upon by the Ripstein procedure. Indications for operation were, in most cases, incontinence for gas and/or feces. Seventy-five per cent of the preoperatively incontinent patients were, at follow-up 2 to 10 years after operation, continent. When indications for surgery were pain and or a sensation of obstruction, the results were poor; most of these patients had unchanged symptoms postoperatively, and some even had increased symptoms. There was one postoperative death. Of 50 patients treated conservatively during a period of 2 to 10 years, only two had to be operated upon: one due to the development of a rectal prolapse and the other due to severe pain and an increased sensation of obstruction.

Rectoanal Intussusception: Presentation of the Disorder and Late Results of Resection Rectopexy

“…1,2 However, it has been also suggested that rectoanal intussusception is a normal variation of straining at stool, and only a very small minority of subjects with internal procidentia develop overt rectal prolapse. [3][4][5] Overt rectal prolapse is usually manifested by constipation, obstructed defecation, incomplete evacuation, and persistent urge to defecate. Mucus and blood discharge per anus is not uncommon, often as a result of a coexisting rectal ulcer.…”

Long-Term Follow-Up of Simultaneous Abdominoperineal Repair of Enterorectocele and Internal Mucosal Prolapse

“…The management of recto-rectal intussusception by sacral rectopexy has yielded poor long-term results, 30 although results for resection rectopexy have been inconsistent. Whereas Brown et al 2 reported negative outcomes in 50% of patients with constipation, Tsiaoussis et al 23 reported positive results in most cases.…”

Improvement in irritable bowel syndrome following ano-rectal surgery

“…Several observers have suggested that prolapsing mucosa may be much more significant than often thought and may be the underlying pathogenic mechanism for various ano-rectal symptoms [28]. It is widely recognised that prolapsing mucosa is the most common cause of 'obstructed defaecation' [29], with symptoms of difficulty in completely emptying the rectum, anal pain or discomfort and a mucous and blood discharge from the rectum and abdominal pains [30,31,32,33]. Awad et al [34] have also suggested that in patients with IBS many symptoms have their origin in the recto-anal segment and have abnormalities in pelvic floor mobility.…”