How is rectal prolapse graded?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 25, 2024
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Rectal prolapse is generally graded into three degrees: first degree rectal prolapse, second degree rectal prolapse, and third degree rectal prolapse. First degree rectal prolapse is a relatively minor condition where the rectal mucosa protrudes but can retract back on its own. Second degree rectal prolapse is a moderate condition where the protruding mucosa extends approximately 5-10 centimeters, generally forming a conical shape, and requires the patient to manually reposition it. Third degree rectal prolapse indicates a severe condition, with the prolapsed mucosa typically extending beyond 10 centimeters. It may protrude with each incident and could also occur when the patient strains the abdomen or squats. The treatment of second and third degree rectal prolapse generally requires surgical intervention.

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Written by Chen Tian Jing
Colorectal Surgery
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What is the pathogenic mechanism of rectal prolapse?

The pathogenic mechanism of rectal prolapse primarily refers to the relaxation and sagging of the rectal mucosa down to the anal area, forming an internal rectal mucosa prolapse. Excessive relaxation of the rectal mucosa can protrude externally through the anus in a cylindrical or conical shape, commonly known as external rectal mucosa prolapse or rectal prolapse. The causes are mainly due to congenital deficiency of kidney energy in patients or excessive relaxation of the rectal mucosa due to multiple childbirths. Some patients with long-term constipation may also experience rectal mucosal relaxation due to excessive straining during bowel movements. Additionally, elderly and frail patients may experience sagging of the rectal mucosa as they age.

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Written by Deng Heng
Colorectal Surgery
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Postoperative Care for Rectal Prolapse Surgery

Post-Rectal Prolapse Surgery Precautions: 1. Rest in bed, which helps improve the recovery rate. Due to gravity, many patients with rectal prolapse experience prolapse when standing or walking. Although the surgery fixes the prolapsed mucosa, the firmness of the fixation takes time to establish. Therefore, it is recommended to rest in bed with limited activity for one week after the surgery to solidify the therapeutic effects. 2. Take oral antibiotics for 7 to 10 days after surgery. 3. Abstain from food for the first two days after surgery, and consume semi-liquid or liquid foods in reduced quantities on the third day. 4. Refrain from defecating for 4 to 5 days after surgery. 5. Do not strain during the first bowel movement after surgery. (Please use medications under the guidance of a professional physician)

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Written by Chen Tian Jing
Colorectal Surgery
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Clinical manifestations of rectal prolapse

The clinical manifestations of rectal prolapse mainly involve the contents within the anal canal, especially the prolapse of the rectal mucosa outside the anus, which is most common. Severe cases of rectal prolapse may lead to a cylindrical or conical prolapse. The common type of rectal prolapse mainly refers to rectal prolapse, but there can also be internal prolapse of the rectal mucosa. Internal prolapse of the rectal mucosa is characterized by excessive relaxation and accumulation of the rectal mucosa at the anus, causing symptoms such as a sense of blockage, downward pressure, and obstruction during bowel movements. This can be definitively diagnosed through an anal examination and defecography. Regardless of whether it is internal prolapse of the rectal mucosa or rectal prolapse, when the disease progresses to a severe degree affecting the patient's normal life, surgical treatment is recommended.

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Written by Chen Tian Jing
Colorectal Surgery
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Which department to consult for rectal prolapse?

Rectal prolapse is generally divided into internal mucosal prolapse and external prolapse. External mucosal prolapse is commonly known as rectal prolapse, which falls under the category of proctological diseases. Therefore, patients who suspect they have rectal prolapse should promptly visit a proctology department for relevant examinations and treatment. The examination and diagnosis of rectal prolapse mainly involve digital rectal examination, anoscopy, and defecography to confirm the diagnosis. Especially for internal mucosal prolapse, which cannot be seen with the naked eye, defecography is necessary for differentiation. In cases of rectal prolapse, one can generally see a ring-like protrusion outside the anus, and in severe cases, there may be conical or cylindrical prolapse. Regardless of whether it is internal mucosal prolapse or rectal prolapse, surgical treatment is necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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Can rectal prolapse cause stool deformity?

Rectal prolapse primarily refers to the excessive relaxation of the rectal mucosa. It may manifest as relaxation of the rectal mucosa due to the prolapse, and may also result in rectal prolapse. Patients with rectal prolapse may experience deformed stools, mainly because the prolapse overly crowds the anal opening, preventing feces from being normally expelled from the body. When feces are expelled through the anus, the local mucosal compression can cause the stools to appear in thin strips or in a flattened shape. Patients with rectal mucosal prolapse are advised to undergo examinations as soon as possible and actively receive treatment. Options include traditional Chinese medicine retention enemas, combined with oral qi-boosting medications. If the prolapse recurs, or has resulted in rectal prolapse, surgical treatment is recommended.