Surgical care of massive rectal prolapse

Summary and Conclusions Massive rectal prolapse is due to a loss of the normal posterior curve of the rectum and rectosigmoid in which the rectum becomes a straight tube and intra-abdominal pressure is exerted in its long axis, causing intussusception. Anterior rectal displacement takes place because of a congenital mesorectum or loose presacral areolar tissue that prevents fixation of the rectum posteriorly in the hollow of the sacrum. Anterior displacement of the rectum may be demonstrated by lateral x-ray and cinefluorography of the barium-filled rectum while the patient is straining. Rectal prolapse can be corrected by posterior fixation of the rectum and rectosigmoid using a Teflon® mesh sling.