Complete Rectal Prolapse Terminology
A complete rectal prolapse is called external (extra-anal) intussusception or procidentia. 1
Definition and Classification
Complete rectal prolapse is characterized by:
- Circumferential, full-thickness protrusion of the rectum through the anus 1
- Involves the entire wall of the rectum (and sometimes sigmoid colon) 1
- Distinguished from internal rectal prolapse which remains within the rectum or anal canal 1
The terminology can be broken down as follows:
- External intussusception: Refers to the infolding of the rectal wall that has protruded beyond the anal verge 1
- Procidentia: The traditional medical term specifically referring to complete rectal prolapse 2
- Type III prolapse: Another term used to describe full-thickness rectal prolapse 3
Distinguishing Features from Other Conditions
Complete rectal prolapse must be differentiated from:
- Prolapsed hemorrhoids: These present as radial bulging of discrete anal cushions, whereas complete rectal prolapse involves concentric protrusion 1
- Partial thickness prolapse: Involves only the mucosa rather than full-thickness rectal wall 1
- Internal rectal prolapse: Classified as intrarectal or intra-anal intussusception that does not protrude beyond the anal verge 1
Clinical Significance
Complete rectal prolapse:
- Has an incidence of approximately 2.5 per 100,000 inhabitants 1
- Is more common in females with a women:men ratio of 9:1 1
- Prevalence of 1% in adults over 65 years 1
- Can become incarcerated or strangulated in emergency situations, requiring prompt treatment 1
- Associated with significant impact on quality of life, including symptoms of pain, incomplete evacuation, bloody/mucous discharge, and fecal incontinence or constipation 2
Complications
When a complete rectal prolapse becomes complicated, it may present as:
- Incarcerated rectal prolapse: External prolapse that cannot be reduced manually 1
- Strangulated rectal prolapse: When blood supply is compromised, leading to potential necrosis and perforation 1
Understanding the correct terminology is essential for proper diagnosis, communication among healthcare providers, and selection of appropriate treatment strategies for this condition.