Internal rectal prolapse

Internal rectal prolapse (IRP) is medical condition involving a telescopic, funnel-shaped infolding of the wall of the rectum that occurs during defecation. The term IRP is used when the prolapsed section of rectal wall remains inside the body and is not visible outside the body. IRP is a type of rectal prolapse. The other main types of rectal prolapse are external rectal prolapse (where the prolapsed segment of rectum protrudes through the anus and is visible externally) and rectal mucosal prolapse (where only the mucosal layer of the wall of the rectum prolapses).

IRP may not cause any symptoms, or may cause obstructed defecation syndrome (difficulty during defecation) and/or fecal incontinence. The causes are not clear. IRP may represent the first stage of a progressive condition that eventually may result in external rectal prolapse. However, it is uncommon for IRP to progress to external rectal prolapse. It is possible that chronic straining during defecation (dyssynergic defecation / anismus), connective tissue disorders, and anatomic factors (e.g. loose connection of rectum to the sacrum, redundant sigmoid, deep pouch of Douglas) are involved. If IRP is causing symptoms, treatment is by various non surgical measures such as biofeedback, or surgery. The most common surgical treatment for IRP is ventral rectopexy.

IRP is often associated with other conditions such as rectocele, enterocele, or solitary rectal ulcer syndrome. IRP usually affects females who have given birth at least once, but it may sometimes affect females who have never given birth. About 10% of cases of IRP are in males. More severe forms of IRP are associated with older age.