Etiology and Treatment of Rectal Prolapse

Two hundred eleven cases of complete rectal prolapse receiving various operative procedures are reported. Many causations of and inducements to the development of rectal prolapse have been reported, but its true etiology has not been clarified yet. Some etiological factors may be involved each in the prolapse to a different degree. For the surgery of complete rectal prolapse, we have so far adopted mainly rectopexy procedure, i. e. unilateral peritoneal incision, posterior mobilization and upward fixation of rectum to the ligament, and repair of pelvic floor and resection of redundant bowel segment ; good results were reflected by its recurrence rate of 13% or so. Recently however, we are adopting less invasive procedure, i. e. Gant-Miwa operation (perineal plication method of prolapsed rectal mucosa) with Thiersch wiring (a total of 84 cases). In view of its recurrence rate of about 24% and of its rare incidence of complicated infection only of the Thiersch-wired region, the present procedure, which is simple but effective, can be worthy of trial.