II．直腸脱の診断と骨盤底機能評価法

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  • Investigation of Patients with Rectal Prolapse

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In the diagnosis of rectal prolapse, it is quite unmistakable when a typical protruded mucosa from the anus is present with sulcus in a concentric ring. It is also helpful when differentiating radial furrows are found in mucosal prolapse. Recent advances in the dynamic study of pelvic floor imaging have shown that rectal prolapse is accompanied with pelvic organ prolapse, such as cystocele, enterocele, and rectocele. Moreover, through inter-professional collaboration between urologists and gynecologists, many physicians have understood that there are overlapping pathophysiologies among these pelvic conditions. Pelvic floor disorders may also be a cause of urinary, defecatory and sexual disturbance which greatly affect the patient's quality of life. From this point of view it is not enough to demonstrate the existence or severity of rectal eversion; either anatomical or functional abnormality associated with rectal prolapse should be observed. A comprehensive evaluation includes addressing anterior and/or middle pelvic organ descent as well as their continence status. This article reviews investigations of rectal prolapse as pelvic floor disorders.

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