RESUMEN
Rectal prolapse, or procidentia, is a common pathology for the practicing colorectal surgeon. It is associated with lifestyle limiting symptoms for the patient and frequently co-exists with other types of pelvic prolapse making multidisciplinary management key. It is primarily managed with surgical reconstruction. A number of operative approaches exist, and the optimum procedure is varied dependent upon patient characteristics.
Asunto(s)
Prolapso Rectal , Humanos , Prolapso Rectal/cirugía , Prolapso Rectal/diagnóstico , Prolapso Rectal/terapiaRESUMEN
Rectosigmoid solitary juvenile polyps are benign lesions, relatively frequent in childhood. The clinical debut of a pediatric polyp with bleeding is relatively frequent, but there are very few reports of rectal prolapse of polyps. We present the case of a 7-year-old female patient with no previous history who presented with rectal prolapse of a polyp with acute bleeding. An urgent endoscopic examination was performed and 2 rectosigmoid polypoid lesions were found and resected. The anatomopathological study showed that these were 2 hamartomatous polyps with mild dysplasia. The patient is asymptomatic and is being followed up. The literature concerning rectal prolapse of polyps in the pediatric population is scarce. In a pediatric patient with a rectal prolapse, this entity should be considered in the differential diagnosis.
Asunto(s)
Hemorragia Gastrointestinal , Prolapso Rectal , Humanos , Prolapso Rectal/diagnóstico , Prolapso Rectal/patología , Prolapso Rectal/etiología , Femenino , Niño , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/patología , Pólipos Intestinales/patología , Pólipos Intestinales/diagnóstico , Pólipos Intestinales/complicaciones , Diagnóstico DiferencialRESUMEN
INTRODUCTION: A rectal prolapse is mainly a disease of the elderly population, occurring more frequently among women. The medical practitioner has an important role in the recognition and initiation of therapy for rectal prolapse. Appropriate therapy can have an important impact on symptom reduction and healthcare resources. Surgical therapy includes perineal or transabdominal surgery, with increasing use of minimally invasive techniques such as mesh rectopexy. This operation is indicated and feasible regardless of age. The management of the rectal prolapse in specialized pelvic floor centres with interdisciplinary expertise for diagnosis and therapy is recommended.
Asunto(s)
Intususcepción , Laparoscopía , Prolapso Rectal , Humanos , Femenino , Anciano , Prolapso Rectal/diagnóstico , Prolapso Rectal/etiología , Prolapso Rectal/cirugía , Defecación , Intususcepción/diagnóstico , Intususcepción/etiología , Intususcepción/cirugía , Resultado del Tratamiento , Diafragma Pélvico , Recto/cirugía , Mallas Quirúrgicas , Laparoscopía/métodosRESUMEN
Anorectal emergencies are rare presentations of common anorectal disorders, and surgeons are often called on to assist in their diagnosis and management. Although most patients presenting with anorectal emergencies can be managed nonoperatively or with a bedside procedure, surgeons must also be able to identify surgical anorectal emergencies, such as gangrenous rectal prolapse. This article provides a review of pertinent anatomy; examination techniques; and workup, diagnosis, and management of common anorectal emergencies including thrombosed hemorrhoids, incarcerated hemorrhoids, anal fissure, anorectal abscess, rectal prolapse, and pilonidal abscess and unique situations including rectal foreign body and anorectal sexually transmitted infections.
Asunto(s)
Enfermedades del Ano , Fisura Anal , Hemorroides , Enfermedades del Recto , Prolapso Rectal , Humanos , Hemorroides/terapia , Hemorroides/cirugía , Prolapso Rectal/diagnóstico , Prolapso Rectal/terapia , Absceso/diagnóstico , Absceso/terapia , Urgencias Médicas , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/terapia , Enfermedades del Ano/diagnóstico , Enfermedades del Ano/terapia , Fisura Anal/diagnóstico , Fisura Anal/terapiaRESUMEN
This case series presents two patients with symptoms consistent with acute rectal prolapse. The prolapses were subsequently found to be sigmoid intussusception that had prolapsed through the anus without rectal prolapse and without any intraluminal pathology or lead point. Both were recognised on examination and underwent colonic resection rather than proctectomy.
Asunto(s)
Intususcepción , Prolapso Rectal , Humanos , Colon , Colon Sigmoide , Intususcepción/diagnóstico , Intususcepción/etiología , Intususcepción/cirugía , Prolapso Rectal/complicaciones , Prolapso Rectal/diagnósticoRESUMEN
A five-month-old alpaca cria presented with a history of abdominal pain, dysuria, and a recurring rectal prolapse. An ultrasonographic examination indicated a urachal abscess attached to the urinary bladder. The abscess was removed surgically, and the patient had an adequate recovery after the procedure and ancillary treatment. This case report highlights secondary complications that could arise following an infection of the urachus in new-world camelids. Key clinical message: Urachal abscess should be considered as a differential diagnosis in juvenile new-world camelids with rectal prolapse, tenesmus, or dysuria.
Prolapsus rectal secondaire à un abcès de l'ouraque chez un cria d'alpaga. Un cria d'alpaga âgé de cinq mois est présenté avec des antécédents de douleurs abdominales, de dysurie et de prolapsus rectal récurrent. Un examen échographique a révélé un abcès de l'ouraque attaché à la vessie. L'abcès a été enlevé chirurgicalement, et le patient a eu une récupération adéquate après la procédure et le traitement auxiliaire. Ce rapport de cas met en évidence les complications secondaires qui pourraient survenir à la suite d'une infection de l'ouraque chez les camélidés du nouveau monde.Message clinique clé :L'abcès de l'ouraque doit être considéré comme un diagnostic différentiel chez les camélidés juvéniles du nouveau monde présentant un prolapsus rectal, un ténesme ou une dysurie.(Traduit par Dr Serge Messier).
Asunto(s)
Camélidos del Nuevo Mundo , Prolapso Rectal , Uraco , Infecciones Urinarias , Animales , Absceso/cirugía , Absceso/veterinaria , Absceso/diagnóstico , Prolapso Rectal/diagnóstico , Prolapso Rectal/cirugía , Prolapso Rectal/veterinaria , Disuria/veterinaria , Infecciones Urinarias/veterinariaRESUMEN
Rectosigmoid intussusception is a rare cause of bowel obstruction, accounting for only approximately 1%-2% of all bowel obstruction cases. While intussusception in adults typically occurs intra-abdominally and presents with signs and symptoms of intestinal obstruction, in rare cases, it can mimic a rectal prolapse if the intussusceptum protrudes through the anal canal. We herein report a case where an octogenarian woman presented with rectosigmoid intussusception through the anal canal, due to a sigmoid colon submucosal lipoma, who eventually required an open Hartmann's procedure. Patients with rectal prolapse symptoms should be carefully examined to rule out intussuscepting masses as a differential, as it would necessitate earlier surgical intervention.
Asunto(s)
Neoplasias del Colon , Obstrucción Intestinal , Intususcepción , Lipoma , Prolapso Rectal , Adulto , Femenino , Anciano de 80 o más Años , Humanos , Prolapso Rectal/diagnóstico , Prolapso Rectal/etiología , Prolapso Rectal/cirugía , Intususcepción/diagnóstico por imagen , Intususcepción/etiología , Recto , Neoplasias del Colon/diagnóstico , Obstrucción Intestinal/complicaciones , Lipoma/diagnóstico , Lipoma/diagnóstico por imagenRESUMEN
BACKGROUND: Rectal intussusception is often observed in patients with faecal incontinence and obstructed defaecation. The aim of this study is to assess if pelvic floor training improves faecal incontinence and obstructed defaecation in patients with rectal intussusception. METHODS: Case notes of all patients referred to Bankstown Hospital Pelvic Floor Clinic between 2013 and 2018 for the management of faecal incontinence and obstructed defaecation and rectal intussusception were retrospectively reviewed using a prospectively maintained database. St Mark's faecal incontinence and Cleveland clinic constipation scores were obtained from patients before and after they underwent pelvic floor training. RESULTS: One hundred and thirty-one patients underwent pelvic floor training at Bankstown Hospital Pelvic Floor Clinic between 2013 and 2018. Sixty-one patients had rectal intussusception (22 low-grade and 39 high-grade). Median St Marks score improved following pelvic floor training from 8 to 1 (P < 0.001). Median Cleveland Clinic constipation score improved from 8 to 5 (P < 0.001). In patients with low grade rectal intussusception, pelvic floor training improved median St Mark's score from 3 to 0 (P = 0.003), whereas Cleveland Clinic constipation score improved from 9 to 7 (P < 0.001). In patients with high-grade rectal intussusception, pelvic floor training improved median St Mark's score from 9 to 2 (P < 0.001), whereas median Cleveland Clinic constipation score improved from 8 to 4 (P < 0.001). CONCLUSION: Pelvic floor training without biofeedback therapy improves faecal incontinence and obstructed defaecation. Improvement in symptoms is unrelated to rectal intussusception observed on proctography or at examination under anaesthesia in these patients.
Asunto(s)
Incontinencia Fecal , Intususcepción , Prolapso Rectal , Humanos , Incontinencia Fecal/etiología , Incontinencia Fecal/terapia , Intususcepción/complicaciones , Intususcepción/terapia , Defecación , Prolapso Rectal/diagnóstico , Estudios Retrospectivos , Diafragma Pélvico , Resultado del Tratamiento , Estreñimiento/etiología , Estreñimiento/terapiaRESUMEN
BACKGROUND AND STUDY AIMS: Outlet obstructive constipation (OOC) is a common type of chronic constipation that is usually caused by internal hemorrhoids (IH) and rectal mucosal prolapse (RMP). Cap-assisted endoscopic sclerotherapy (CAES) was demonstrated to be effective in the treatment of IH and RMP. This study explored the efficacy of CAES in treating OOC associated with IH and RMP. METHODS: Thirty-one patients (15 males and 16 females) were diagnosed with OOC after colonoscopy and anorectal manometry (AM). CAES was used to treat IH and RMP. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Wexner constipation score (WCS) were used to assess patients at baseline and at the end of follow-up. AM tests were performed before and after CAES. RESULTS: The mean age of patients was 56.19 ± 7.969 years, and the follow-up time was 2.875 ± 3.703 months. After CAES treatment, subjective indices, including frequency of bowel movements (p < 0.05), defecation time (p < 0.05), SAS (p < 0.05), SDS (p < 0.05), and WCS (p < 0.05), were significantly improved. AM showed that the anal relaxation rate (p < 0.05), maximum squeeze pressure (p < 0.05), and rectal residual pressure (p < 0.05) were significantly improved. The ratio of Bristol stool form scale typeIII-Vincreased from 12.5 % to 56.25 % (p < 0.05). CONCLUSIONS: CAES is effective for treating OOC caused by IH and RMP. The relief of OOC symptoms could improve anxiety and depression symptoms associated with the disease.
Asunto(s)
Hemorroides , Prolapso Rectal , Masculino , Femenino , Humanos , Persona de Mediana Edad , Escleroterapia/efectos adversos , Prolapso Rectal/complicaciones , Prolapso Rectal/terapia , Prolapso Rectal/diagnóstico , Estreñimiento/etiología , Estreñimiento/terapia , Estreñimiento/diagnóstico , Recto , Hemorroides/complicaciones , Hemorroides/terapia , Canal Anal , Manometría/efectos adversos , DefecaciónRESUMEN
Los lipomas colónicos son tumores benignos poco frecuentes, extremadamente raros a nivel rectal. A pesar de ello, ocupan el segundo lugar en frecuencia detrás de los pólipos adenomatosos. Aunque la mayoría de los lipomas colorrectales son asintomáticos y se descubren incidentalmente, en ocasiones pueden ser sintomáticos y determinar complicaciones agudas que requieren tratamiento quirúrgico de urgencia. Estas formas de presentación pueden confundirse con las del cáncer colorrectal, constituyendo un desafío diagnóstico y terapéutico. Presentamos el caso de una paciente que consultó en emergencia por una gran masa dolorosa de aparición aguda a nivel del ano, resultando ser un lipoma rectal prolapsado a través del canal anal.
Colonic lipomas are infrequent benign tumors, extremely rare at the rectum. Nevertheless, they follow in frequency polyp adenomas. Even though most colorectal lipomas are asymptomatic and incidental, they can occasionally be symptomatic and develop acute complications that require urgent surgical treatment. This form of presentation can be confounded with colorectal cancer, therefore impairing diagnosis and treatment. We present the case of a female patient who came to the emergency room with an acute painful mass through the anus, that resulted in a prolapsed rectal lipoma.
Os lipomas colônicos são tumores benignos pouco frequentes, extremamente raros no nível retal. Apesar disso, ocupam o segundo lugar em frequência atrás dos pólipos adenomatosos. Embora a maioria dos lipomas colorretais sejam assintomáticos e descobertos incidentalmente, às vezes eles podem ser sintomáticos e levar a complicações agudas que requerem tratamento cirúrgico de emergência. Essas formas de apresentação podem ser confundidas com as do câncer colorretal, constituindo um desafio diagnóstico e terapêutico. Apresentamos o caso de um paciente que consultou na sala de emergência por uma grande massa dolorosa de início agudo ao nível do ânus, que acabou por ser um lipoma retal prolapsado pelo canal anal.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Canal Anal/patología , Neoplasias del Recto/diagnóstico , Prolapso Rectal/diagnóstico , Lipoma/diagnóstico , Canal Anal/cirugía , Neoplasias del Recto/cirugía , Prolapso Rectal/cirugía , Dolor en Cáncer , Lipoma/cirugíaRESUMEN
Surgery is currently the only cure for rectal prolapse. Standardized preoperative evaluation and appropriate selection of surgical methods are crucial to the outcome of rectal prolapse surgery. With the development of a series of clinical studies in China and abroad, transabdominal surgery (such as ventral mesh fixation) and transperineal (anal) surgery (such as Altemeier surgery) have been widely recognized. Precise preoperative assessment of rectal prolapse and appropriate selection of surgical approaches has important clinical value in reducing postoperative recurrence rates and surgical-related complications. However, the current rectal prolapse assessment system needs to be improved, and the choice of surgical procedures remains controversal. To guide the diagnosis and surgical treatment of patients with rectal prolapse in China, nationwide specialists of colorectal and pelvic floor surgery have been organized by the of Chinese Medical Doctor Association Anorectal Branch, the Pelvic Floor Surgery Committee, and Clinical Guidelines Committee. Experts have conducted rounds of discussions on the core content of standardized diagnosis and surgical treatment for rectal prolapse, and jointly formulated the "Chinese expert consensus on the diagnosis and surgical treatment of rectal prolapse (2022)". We hope that this consensus will provide useful resources for the colorectal and pelvic floor surgeons, and promote the standardization of diagnosis and surgical treatment for the rectal prolapse in China.
Asunto(s)
Neoplasias Colorrectales , Prolapso Rectal , Humanos , Prolapso Rectal/diagnóstico , Prolapso Rectal/cirugía , Prolapso Rectal/complicaciones , Consenso , Pueblos del Este de Asia , Resultado del Tratamiento , Neoplasias Colorrectales/complicaciones , Mallas Quirúrgicas/efectos adversosRESUMEN
BACKGROUND: The effectiveness of laparoscopic ventral mesh rectopexy (LVMR) in patients with defecatory disorders secondary to internal rectal prolapse is poorly evidenced. A UK-based multicenter randomized controlled trial was designed to determine the clinical efficacy of LVMR compared to controls at medium-term follow-up. METHODS: The randomized controlled trial was conducted from March 1, 2015 TO January 31, 2019. A stepped-wedge RCT design permitted observer-masked data comparisons between patients awaiting LVMR (controls) with those who had undergone surgery. Adult participants with radiologically confirmed IRP refractory to conservative treatment were randomized to three arms with different delays before surgery. Efficacy outcome data were collected at equally stepped time points (12, 24, 36, 48, 60, and 72 weeks). Clinical efficacy of LVMR compared to controls was defined as ≥ 1.0-point reduction in Patient Assessment of Constipation-Quality of Life and/or Symptoms (PAC-QOL and/or PAC-SYM) scores at 24 weeks. Secondary outcome measures included 14-day diary data, the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), St Marks incontinence score, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), the chronic constipation Behavioral Response to Illness Questionnaire (CC-BRQ), and the Brief Illness Perception Questionnaire (BIPQ). RESULTS: Of a calculated sample size of 114, only 28 patients (100% female) were randomized from 6 institutions (due mainly to national pause on mesh-related surgery). Nine were assigned to the T0 arm, 10 to T12, and 9 to T24. There were no substantial differences in baseline characteristics between the three arms. Compared to baseline, significant reduction (improvement) in PAC-QOL and PAC-SYM scores were observed at 24 weeks post-surgery (- 1.09 [95% CI - 1.76, - 0.41], p = 0.0019, and - 0.92 [- 1.52, - 0.32], p = 0.0029, respectively) in the 19 patients available for analysis (9 were excluded for dropout [n = 2] or missing primary outcome [n = 7]). There was a clinically significant long-term reduction in PAC-QOL scores (- 1.38 [- 2.94, 0.19], p = 0.0840 at 72 weeks). Statistically significant improvements in PAC-SYM scores persisted to 72 weeks (- 1.51 [- 2.87, - 0.16], p = 0.0289). Compared to baseline, no differences were found in secondary outcomes, except for significant improvements at 24 and 48 weeks on CC-BRQ avoidance behavior (- 14.3 [95% CI - 23.3, - 5.4], and - 0.92 [- 1.52, - 0.32], respectively), CC-BRQ safety behavior (- 13.7 [95% CI - 20.5, - 7.0], and - 13.0 [- 19.8, - 6.1], respectively), and BIPQ negative perceptions (- 16.3 [95% CI - 23.5, - 9.0], and - 10.5 [- 17.9, - 3.2], respectively). CONCLUSIONS: With the caveat of under-powering due to poor recruitment, the study presents the first randomized trial evidence of short-term benefit of LVMR for internal rectal prolapse. TRIAL REGISTRATION: ISRCTN Registry (ISRCTN11747152).
Asunto(s)
Laparoscopía , Prolapso Rectal , Adulto , Humanos , Femenino , Masculino , Prolapso Rectal/complicaciones , Prolapso Rectal/cirugía , Prolapso Rectal/diagnóstico , Calidad de Vida , Mallas Quirúrgicas , Laparoscopía/efectos adversos , Estreñimiento/cirugía , Estreñimiento/complicaciones , Resultado del Tratamiento , Enfermedad CrónicaRESUMEN
Benign anorectal disease refers to a diverse group of frequent anorectal complaints that cause considerable discomfort, disability, and often constitute a significant problem for the child and his or her family. Hemorrhoids, fissures, rectal prolapse, and perianal abscess and fistulas are the most common anorectal disorders in pediatric population and their appearance may be age-specific. Although they generally follow a benign course, a careful examination must be performed in order to exclude other serious and complicated underlying pathology. Their diagnosis is based on the patient's medical history, physical examination, endoscopy, and imaging. Moreover, the management of these disorders includes medical and surgical treatment options, and if they are treated promptly and properly may be limited and short lived. This review presents the currently available data in the literature on the diverse aspects of these disorders, including the definition, epidemiology, clinical presentation, pathogenesis, diagnosis, indications for surgery, and long-term outcomes.
Asunto(s)
Enfermedades del Ano , Hemorroides , Enfermedades del Recto , Fístula Rectal , Prolapso Rectal , Absceso/diagnóstico , Absceso/terapia , Enfermedades del Ano/diagnóstico , Enfermedades del Ano/epidemiología , Enfermedades del Ano/terapia , Niño , Endoscopía , Femenino , Hemorroides/diagnóstico , Hemorroides/epidemiología , Hemorroides/terapia , Humanos , Masculino , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/epidemiología , Enfermedades del Recto/terapia , Fístula Rectal/diagnóstico , Fístula Rectal/terapia , Prolapso Rectal/diagnóstico , Prolapso Rectal/etiología , Prolapso Rectal/terapiaRESUMEN
OBJECTIVE: To assess patients' long-term outcome and satisfaction after laparoscopic ventral mesh rectopexy (LVMR). SUMMARY OF BACKGROUND DATA: Data on the long-term outcome and satisfaction of patients undergoing LVMR are limited. METHODS: Patients who underwent LVMR between 2004 and 2017 were identified from a prospectively maintained database. We attempted to contact all patients by telephone for an interview using a standardized questionnaire to record pre-LVMR symptoms, long-term outcome, and overall satisfaction. RESULTS: Total number of patients who underwent LVMR was 848 and 99(12%) were deceased at follow-up. In the end, 544 (64%) patients were contacted successfully and 478 (56%) were able to complete the questionnaire. Median time elapsed since surgery was 7 years and mean age was 62 years. Patients' reported preoperative symptoms were obstructed defecation syndrome in 40%, fecal incontinence in 22%, combination of obstructed defecation syndrome and fecal incontinence in 21% and other conditions in 17%. Bowel symptoms were reported as improved by 69% of patients and worse by 12%. Pelvic pain was reported to be improved in 47% of the patients after LVMR but new onset of pelvic pain appeared in 15%. Sexual function was reported to be better and worse with equal frequency. Overall, 63% of the patients were satisfied with the outcome and 76% would recommend this procedure to others with similar symptoms. CONCLUSION: LVMR offers acceptable long-term outcomes and satisfaction. There is a mixed impact on pelvic pain and sexual function which requires careful consideration in counseling patients for this procedure.
Asunto(s)
Incontinencia Fecal , Laparoscopía , Prolapso Rectal , Incontinencia Fecal/etiología , Incontinencia Fecal/cirugía , Humanos , Laparoscopía/métodos , Persona de Mediana Edad , Dolor Pélvico/cirugía , Percepción , Calidad de Vida , Prolapso Rectal/diagnóstico , Prolapso Rectal/cirugía , Recto/cirugía , Mallas Quirúrgicas , Resultado del TratamientoRESUMEN
Mucosal prolapse syndrome most commonly involves the rectum and presents as solitary rectal ulcer syndrome and proctitis cystica profunda. Symptoms and endoscopic appearances are nonspecific. Histologically, mucosal prolapse is characterized by fibromuscular obliteration of the lamina propria, and displacement of crypts into submucosa and muscularis mucosae. Mucosal prolapse presenting as polyposis is rare and has only been reported involving the rectosigmoid colon. In this report, we describe a case of mucosal prolapse syndrome presenting as diffuse polyposis and colitis cystica profunda involving the hepatic, splenic flexures and descending colon in a teenage boy suffering from refractory fibrostenosing Crohn's disease. This patient was found to have possibly deleterious homozygous single nucleotide polymorphisms in both SULT1A1 and SULT1A2 genes within a unique polygenic variation of altered cell adhesion.
Asunto(s)
Poliposis Adenomatosa del Colon , Arilsulfotransferasa/genética , Colectomía/métodos , Enfermedad de Crohn , Mucosa Intestinal , Prolapso Rectal , Inhibidores del Factor de Necrosis Tumoral/uso terapéutico , Poliposis Adenomatosa del Colon/diagnóstico , Poliposis Adenomatosa del Colon/etiología , Adolescente , Adhesión Celular/genética , Colitis/diagnóstico por imagen , Colitis/etiología , Colitis/patología , Colonoscopía/métodos , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/genética , Enfermedad de Crohn/fisiopatología , Pruebas Genéticas/métodos , Humanos , Mucosa Intestinal/diagnóstico por imagen , Mucosa Intestinal/patología , Imagen por Resonancia Magnética/métodos , Masculino , Polimorfismo de Nucleótido Simple , Prolapso Rectal/diagnóstico , Prolapso Rectal/etiología , Índice de Severidad de la EnfermedadAsunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Diafragma Pélvico/cirugía , Prolapso Rectal/cirugía , Recto/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/instrumentación , Humanos , Diafragma Pélvico/patología , Perineo/patología , Perineo/cirugía , Prolapso Rectal/diagnóstico , Prolapso Rectal/etiología , Prolapso Rectal/patología , Recto/patología , Mallas QuirúrgicasRESUMEN
BACKGROUND: Clinically diagnosing high-grade (III-V) rectal prolapse might be difficult, and the prolapse can often be overlooked. Even though defecography is the significant diagnostic tool for rectal prolapse, it is noticed that rectoanal inhibitory reflex (RAIR) can be associated with rectal prolapse. This study investigated whether RAIR can be used as a diagnostic factor for rectal prolapse. METHODS: In this retrospective study, we evaluated 107 patients who underwent both anorectal manometry and defecography between July 2012 and December 2019. Rectal prolapse was classified in accordance with the Oxford Rectal Prolapse Grading System. Patients in the high-grade (III-V) rectal prolapse (high-grade group, n = 30), and patients with no rectal prolapse or low-grade (I, II) rectal prolapse (low-grade group, n = 77) were analyzed. Clinical variables, including symptoms such as fecal incontinence, feeling of prolapse, and history were collected. Symptoms were assessed using yes/no surveys answered by the patients. The manometric results were also evaluated. RESULTS: Frequencies of fecal incontinence (p = 0.002) and feeling of prolapse (p < 0.001) were significantly higher in the high-grade group. The maximum resting (77.5 vs. 96 mmHg, p = 0.011) and squeezing (128.7 vs. 165 mmHg, p = 0.010) anal pressures were significantly lower in the high-grade group. The frequency of absent or impaired RAIR was significantly higher in the high-grade group (19 cases, 63% vs. 20 cases, 26%, p < 0.001). In a multivariate analysis, the feeling of prolapse (odds ratio [OR], 23.88; 95% confidence interval [CI], 4.43-128.78; p < 0.001) and absent or impaired RAIR (OR, 5.36; 95% CI, 1.91-15.04, p = 0.001) were independent factors of high-grade (III-V) rectal prolapse. In addition, the percentage of the absent or impaired RAIR significantly increased with grading increase of rectal prolapse (p < 0.001). The sensitivity of absent or impaired RAIR as a predictor of high-grade prolapse was 63.3% and specificity 74.0%. CONCLUSIONS: Absent or impaired RAIR was a meaningful diagnostic factor of high-grade (III-V) rectal prolapse. Furthermore, the absent or impaired reflex had a positive linear trend according to the increase of rectal prolapse grading.