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What is Rectal Prolapse?
Rectum is the organ that provides intestinal evacuation. It is located in the lower part of the abdomen, in an area called the pelvic region, which is surrounded by bone, muscle, and connective tissue. When there is no pregnancy, there is an opening called the vagina for the menstrual bleeding to flow out, for the sperm to pass through for pregnancy, and for the delivery of the baby in case of pregnancy.
A section of the intestine also corresponds to the lower part of this opening. While the above-mentioned uterine functions can be performed thanks to the vaginal opening, a potential weak area is formed in the lower abdomen due to the same vaginal opening, and the uterus, bladder, or intestines can come down from this weak area and even go out of the body through the vagina. Here, the condition of displacement of the intestine, which should normally be located in the pelvic region in the abdomen, down the vagina and even hanging out of the vagina, is called rectal prolapse.
How does Rectal Prolapse Occur?
Both the small intestine and the large intestine can be pocketed, causing drooping out of the vagina. This occurs due to the relaxation of the pelvic floor. The most common causes of relaxation of the pelvic floor can be listed as follows: Normal birth (vaginal birth), episiotomy opening during normal birth, use of vacuum or forceps in difficult births, constipation, excessive straining on the toilet, age, cough, menopause, lifestyle, obesity, connective tissue diseases, systemic diseases such as diabetes, uterine and intestinal surgeries. With the increase in intra-abdominal pressure, the organs in the lower abdomen go down further and the muscles and ligaments here are faced with strain. All these situations destroy the supporting tissues in the pelvis.
What are the Symptoms of Rectal Prolapse?
Rectal prolapse can be mild or severe. Mild cases may not have any complaints. The most frequently mentioned complaints by the patients as the degree increases: change in defecation, not being able to empty when going to the toilet, the desire to go to the toilet frequently during the day, the need to support with hands while defecating, constipation, pain in the breech area, pain that can change with position during sexual intercourse, in the form of bleeding. Some symptoms vary according to the degree of bladder prolapse. All complaints can be evaluated by examination at the doctor's application.
How is Rectal Prolapse Diagnosed?
Rectal prolapse is diagnosed with a normal gynecological examination. Since the gynecological examination is performed in patients with the above complaints, visualization of the intestine that does not protrude from the vagina or that has protruded is sufficient for the diagnosis. In cases of early-stage rectal prolapse, if the mass protruding from the vagina cannot be seen during the gynecological examination, it may be necessary to examine it by pushing the patient on the table or by pushing after he/she stands up. In the patient who is standing up or straining, the rectum protruding from the vagina can be seen and the diagnosis of rectal prolapse can be made.
How is Rectal Prolapse Treated?
Today, rectal prolapse surgery is frequently performed and there are very effective methods. If these operations are performed by experienced surgeons, the risk of complications will be less, and life-long permanent treatments will be provided. With the removal of excess tissue, support is obtained from the surrounding tissues in the form of a patch, and that area is strengthened. Almost all the patients with rectal prolapse surgery stay in the hospital for only one night, are discharged the next day, and return to their daily lives within a few days. Most of the patients do not seek treatment because they see this problem as a problem encountered in the natural flow of life and must be endured, and because they do not talk about the problem with the thought of privacy. However, knowing the existence of methods used in the treatment of rectal prolapse in today's modern medicine and providing permanent treatment for life will both contribute positively to the search for treatment and provide an opportunity for patients to get rid of this problem for life.