Rectal mucosa protruding through the anus, with or without bleeding, discomfort, or mild pain. It can occur to varying degrees. Characterized by a thick dark red or bright red mucosal mass protruding from the rectum (complete procidentia) or redundant rectal mucosa proceeding through the anal sphincter (partial procidentia).
It can occur in men and women, but is most common in women beyond the fourth decade. It is typically precipitated by straining during a bowel movement, or by persistent coughing, forceful vomiting, and passing of intestinal parasites. Prior abdominal surgery, particularly for pelvic organ prolapse, and vaginal delivery of large birth weight infants may be contributing factors.
Mild prolapse may be self-limited, resolving spontaneously. In chronic prolapse, patients may experience fecal incontinence, and bowel movements may be obstructed. Rectal ulceration can occur.
Management includes reduction of the prolapse, preventive measures, and surgical procedures.