Rectal prolapse is the descent of the rectum through the anal opening. These lecture notes explain how to recognise and classify prolapse, assess the patient, identify emergencies, understand investigations and treatment, and provide safe perioperative and continuing nursing care.
Urgent-care reminder: a prolapse that is stuck outside, increasingly painful, markedly swollen, dark purple/black, bleeding heavily, or associated with vomiting, abdominal distension, fever, faintness or shock needs urgent surgical assessment. Do not forcefully push compromised tissue back into the rectum.
By the end of this lesson, the learner should be able to:
- Define rectal prolapse and distinguish full-thickness external prolapse from mucosal prolapse and internal intussusception.
- Describe the contributing factors, pathophysiology, clinical features and possible complications.
- Outline focused history-taking, examination, investigations and differential diagnoses.
- Recognise an incarcerated or strangulated prolapse and explain the immediate priorities of care.
- Compare the main abdominal and perineal operations and describe nursing care before and after surgery.
- Teach practical measures that support bowel function, protect dignity and reduce straining and recurrence risk.
Rectal prolapse occurs when the rectum loses some of its normal pelvic attachments and descends downward. In external full-thickness rectal prolapse, the full wall of the rectum protrudes through the anus. The protruding bowel may initially return by itself after defecation; later, the patient may need to reduce it manually, and in advanced disease it may remain outside.
Internal rectal prolapse, also called rectal intussusception, is telescoping of the rectal wall into the rectum or anal canal without tissue being visible outside the anus. Mucosal prolapse involves only the inner lining. These conditions are related but are not interchangeable, and their assessment and treatment differ.
Key point: rectal prolapse is not the same as haemorrhoids. Both can cause a protruding mass, mucus or bleeding, but full-thickness prolapse involves the rectal wall, while haemorrhoids are enlarged vascular cushions in and around the anal canal. Correct examination matters because the management is different.
| Type or description | What descends | Typical finding | Clinical significance |
|---|---|---|---|
| External full-thickness prolapse | The full circumference and thickness of the rectal wall | Red, moist, circumferential tissue protruding through the anus; folds often run concentrically around the prolapse | May cause mucus leakage, bleeding, constipation or faecal incontinence; may become incarcerated or strangulated |
| Mucosal prolapse | The rectal mucosa, without the full rectal wall | Smaller mucosal tissue at the anal opening; appearance can overlap with prolapsing haemorrhoids | Requires examination to establish the cause and distinguish it from other anal lesions |
| Internal prolapse (intussusception) | Rectal wall telescopes into the rectum or anal canal but does not visibly protrude | Obstructed defecation, incomplete emptying or pelvic pressure; external tissue may be absent | May require selected imaging or functional studies when symptoms and examination do not explain the problem |
| Reducible prolapse | External prolapse that returns spontaneously or can be reduced | Appears with straining or a bowel movement and then returns | Needs planned clinical review; progression and bowel dysfunction should be assessed |
| Incarcerated or strangulated prolapse | External prolapse that cannot be returned, with possible compromise of blood flow | Marked oedema, increasing pain, dusky or dark tissue, ulceration, bleeding or systemic illness | Surgical emergency: urgent assessment, resuscitation and treatment are required |
There is rarely one cause. Rectal prolapse is associated with weakening or stretching of the structures that support the rectum and pelvic floor, together with repeated downward pressure during defecation. Constipation and chronic straining are common; some patients instead have chronic diarrhoea or alternating constipation and diarrhoea.
- Pelvic floor and connective-tissue weakness: weakened support, reduced anal sphincter tone, or loss of normal rectal attachments may permit descent.
- Chronic constipation and straining: prolonged effort and repeated increases in intra-abdominal pressure can worsen descent and symptoms.
- Chronic diarrhoea or frequent defecation: repeated bowel movements and urgency may aggravate pelvic floor stress.
- Age and frailty: reduced pelvic floor strength and coexisting illness may affect the likelihood of prolapse and the choice of operation.
- Obstetric and pelvic history: childbirth and pelvic floor injury may contribute in some patients, but rectal prolapse also occurs in people who have never given birth and in men.
- Neurological, developmental or cognitive conditions: impaired coordination, reduced mobility, or difficulty with bowel routines may increase straining or delay recognition.
- In children: assess for persistent diarrhoea, constipation, malnutrition, parasitic disease where clinically indicated, chronic cough, and other underlying conditions rather than assuming adult causes.
- Associated pelvic floor disorders: urinary symptoms, vaginal or perineal bulging, and obstructed defecation may coexist and should be included in the assessment.
- Supportive attachments of the rectum and pelvic floor become weak, stretched or poorly coordinated.
- Repeated straining, difficult stool passage or other pressure causes the rectal wall to descend.
- With early external prolapse, tissue appears during defecation and may return spontaneously.
- As descent progresses, the prolapse may occur with less effort, remain outside, or require manual reduction.
- Repeated exposure causes oedema, irritation, mucus discharge, superficial ulceration or bleeding.
- Stretching of the anal sphincter and pelvic nerves may contribute to faecal incontinence; the prolapse can also obstruct evacuation and worsen constipation.
- If the tissue is trapped outside, swelling may impair venous return and then arterial blood flow. Ischaemia, necrosis, perforation and sepsis are possible in severe untreated cases.
Symptoms vary with the extent of descent and the patient’s bowel function. Ask about symptoms sensitively: embarrassment can delay help-seeking, and the patient may not volunteer information unless asked respectfully.
| Symptom or sign | How it may present | Why it matters |
|---|---|---|
| Protruding tissue | A red or pink mass appears during or after defecation, coughing or straining; it may later remain outside | Establish whether the tissue is reducible, how often it appears and whether it is becoming more difficult to reduce |
| Mucus or moisture | Mucus, fluid or soiling on underwear; perianal irritation | May cause skin breakdown, odour, discomfort and social distress |
| Rectal bleeding | Small amounts of bright blood or bleeding from irritated or ulcerated tissue | Assess amount, duration, vital signs and other causes; significant bleeding needs urgent review |
| Constipation or obstructed defecation | Straining, incomplete emptying, difficulty passing stool or needing to support the perineum | May be both a contributing factor and a consequence of prolapse |
| Faecal incontinence | Difficulty controlling flatus or stool, urgency, or leakage | Assess impact on skin, hydration, dignity and quality of life; symptoms may not resolve fully after repair |
| Discomfort or pain | Pressure, dragging, soreness or pain, especially if tissue is swollen or trapped | Severe, worsening pain with irreducibility or dark tissue is an emergency warning |
| Urinary or pelvic symptoms | Urinary difficulty, pelvic pressure, or vaginal/perineal bulging | May indicate coexisting pelvic floor dysfunction requiring coordinated assessment |
Emergency red flags: irreducible prolapse; severe or rapidly worsening pain; dusky, purple or black tissue; increasing swelling; heavy bleeding; fever; tachycardia; hypotension; abdominal distension; vomiting; inability to pass stool or flatus; confusion or collapse. Escalate immediately for urgent surgical review.
- When did the protrusion first occur? Is it becoming more frequent or larger?
- Does it appear only during defecation, with standing or coughing, or at rest? Does it return by itself, need reduction, or remain outside?
- Ask about pain, bleeding, mucus, itching, skin soreness, constipation, diarrhoea, straining, incomplete emptying, urgency and faecal incontinence.
- Ask about nausea, vomiting, abdominal pain or distension, fever, reduced stool or flatus, weakness and faintness.
- Review medication, fluid and dietary patterns, mobility, chronic cough, neurological conditions, previous pelvic or rectal operations, childbirth history where relevant, and previous treatments.
- Ask about urinary symptoms, pelvic pressure or vaginal/perineal bulging; these may affect the treatment plan.
- Explore the effect on sleep, work, school, relationships and willingness to leave home. Use non-judgmental language and protect privacy.
- Assess airway, breathing, circulation, mental status, pain and overall appearance if the patient is acutely ill. Record vital signs and escalate instability promptly.
- Ask permission, explain each step, provide a chaperone according to local policy and maintain privacy. Use appropriate gloves and infection-prevention precautions.
- Inspect the perianal area for protruding tissue, colour, swelling, bleeding, ulceration, discharge, skin damage and soiling. Document whether the prolapse is visible and whether the patient reports it is reducible.
- Do not repeatedly manipulate the prolapse. A digital rectal examination or a supervised straining assessment is performed by a suitably trained clinician when appropriate; avoid delaying emergency referral to complete a routine examination.
- In a stable patient whose prolapse is not visible, a clinician may arrange observation during straining in a private, appropriate setting. A patient-provided photograph can help document an intermittent prolapse when acceptable to the patient.
- Assess hydration, abdominal distension, bowel sounds when indicated, stool pattern, perianal skin and sphincter function as part of the wider clinical plan.
Rationale: a focused assessment confirms the pattern of prolapse, identifies bowel and pelvic floor dysfunction, protects dignity and helps distinguish routine review from an emergency. The colour and reducibility of the tissue, pain and vital signs are especially important when strangulation is possible.
| Condition | Clues that may help distinguish it | Nursing implication |
|---|---|---|
| Prolapsing haemorrhoids | Protruding vascular cushions; folds may radiate outward rather than form the concentric folds typical of full-thickness rectal prolapse | Do not assume all anal protrusions are haemorrhoids; request appropriate clinical examination |
| Mucosal prolapse | Only the mucosal lining descends; appearance can overlap with haemorrhoids | Document findings without assigning a definitive diagnosis outside scope |
| Anal or rectal polyp / tumour | Focal lesion, altered bowel habit, unexplained bleeding, weight loss or anaemia may be present | Needs clinical assessment and appropriate investigation; a prolapse does not exclude another lesion |
| Rectocele or other pelvic organ prolapse | Pelvic or vaginal bulge, obstructed defecation or urinary symptoms; rectocele bulges into the posterior vaginal wall | Ask about related symptoms and refer for appropriate multidisciplinary assessment |
| Internal intussusception | Telescoping occurs internally, without an obvious external mass | Functional assessment or defecography may be selected by the treating team |
The diagnosis is often suggested by the history and direct examination. Investigations are selected to clarify internal prolapse, assess bowel function, exclude a lead point or other disease, and prepare for an operation; not every patient needs every test.
| Investigation | Purpose | Nursing considerations |
|---|---|---|
| Focused anorectal examination | Assess visible prolapse, mucosal condition, anal tone, sphincter function and associated lesions | Explain the examination, obtain consent, preserve privacy, use a chaperone per policy and report severe pain or suspicious tissue |
| Colonoscopy or flexible endoscopy | Evaluate rectal or colonic mucosa and exclude a polyp, tumour or other bowel disorder when indicated, particularly before repair | Explain preparation and fasting instructions as ordered; monitor hydration and report bleeding or worsening symptoms |
| Defecography (fluoroscopic or MRI) | Shows pelvic organ movement during simulated defecation and can identify internal prolapse or associated pelvic floor disorders | Explain the procedure and positioning; check pregnancy status where relevant to local protocol and modality |
| Anorectal manometry | Measures anal sphincter and rectal pressure, sensation and coordination | Reassure the patient and explain that a small pressure-sensing catheter is used |
| Colonic transit study | May be used in selected patients with longstanding constipation to assess transit time | Reinforce the clinician’s instructions on the marker capsule, medicines and scheduled imaging |
| Laboratory tests | Selected tests may assess anaemia, infection, hydration, renal function or operative fitness | Collect and label specimens correctly; interpret results within the clinical team’s plan |
| Imaging in a complicated prolapse | In a stable patient with irreducible or strangulated prolapse, urgent CT may help assess complications or a possible colorectal lesion when available and when it will not delay treatment | In instability or suspected peritonitis, escalate and prepare for urgent management; do not delay care for imaging |
Incarceration means the prolapsed tissue is trapped outside and cannot be returned. Strangulation means the blood supply is compromised. The patient needs urgent assessment by the surgical team. The nurse should prioritise safe escalation and stabilisation according to the patient’s condition and local emergency protocols.
- Call for urgent senior and surgical review; activate the facility’s emergency response if the patient is unstable.
- Assess and support airway, breathing and circulation; monitor vital signs, mental status, pain and urine output as indicated.
- Keep the patient nil by mouth when urgent surgery is possible, establish IV access and prepare ordered fluids, analgesia, blood tests and cross-match as clinically indicated.
- Position for comfort, protect the exposed tissue from trauma and drying with a clean, moist dressing according to local protocol, and document colour, swelling, pain, bleeding and time of onset.
- Do not apply force or attempt repeated reduction. Any reduction attempt, if judged appropriate, must be directed by a qualified clinician after assessment of viability and patient stability.
- Prepare for imaging only if the patient is stable and it will not delay appropriate treatment; prepare for theatre or transfer as directed.
Safety note: osmotic agents or other methods to reduce oedema are sometimes described in specialist management. Their use is a clinician-led decision and should follow local protocols; they are not a substitute for urgent surgical review when tissue is compromised.
For stable patients, care includes evaluation of constipation, diarrhoea, incontinence, sphincter function, overall fitness and coexisting pelvic floor problems. Fluids, dietary fibre, stool softening, a planned toileting routine, avoiding prolonged straining and treatment of the underlying bowel disorder may improve symptoms and reduce further trauma. Pelvic floor therapy or biofeedback may help selected patients with associated dysfunction.
These measures can support comfort and bowel function but generally do not correct established external full-thickness prolapse. Definitive treatment is usually surgical. The decision and procedure depend on the type and extent of prolapse, bowel symptoms, operative risk, prior surgery, patient goals and available surgical expertise.
| Approach | Examples | General use and nursing relevance |
|---|---|---|
| Abdominal repair | Rectopexy by open, laparoscopic or robotic approach; selected patients may have resection rectopexy | The rectum is mobilised and fixed higher in the pelvis. Often considered for patients fit for abdominal surgery; bowel function may not fully normalise, and constipation can persist or worsen. |
| Perineal repair | Altemeier perineal rectosigmoidectomy or Delorme mucosal sleeve resection | Approaches through the perineum may suit selected older, frail or higher-risk patients and some emergencies. The choice is individual; recurrence and anastomotic or wound complications must be discussed. |
| Supportive bowel management | Individualised fibre/fluid advice, stool softener or laxative plan, treatment of diarrhoea, toileting routine and pelvic floor support | Reduces straining and protects bowel function, before or after surgery; it is not a reliable cure for established full-thickness external prolapse. |
Perineal operations include removal of prolapsed full-thickness bowel (Altemeier procedure) or removal of a mucosal sleeve with plication of the rectal muscle (Delorme procedure). Abdominal rectopexy anchors the rectum to the sacrum using sutures and, in selected techniques, mesh. Resection may be considered when marked sigmoid redundancy and constipation are present. These are specialist decisions; no single operation is best for every patient.
| Nursing action | Rationale |
|---|---|
| Assess baseline bowel pattern, prolapse frequency and reducibility, pain, bleeding, mucus, continence, skin condition and effect on daily life. | Creates a baseline for planning care and evaluating postoperative change; bowel symptoms may continue even after anatomical repair. |
| Observe vital signs and escalate new severe pain, irreducibility, discolouration, fever, heavy bleeding, vomiting or abdominal distension promptly. | These findings may indicate incarceration, ischaemia, obstruction, infection or haemodynamic compromise. |
| Explain examinations and preparations in clear language; obtain consent through the responsible clinician, preserve privacy and offer a chaperone according to policy. | Reduces anxiety and protects dignity during a sensitive anorectal assessment. |
| Review prescribed bowel preparation, fasting, medication adjustment, allergy history, investigations and consent status. | Supports safe anaesthesia and surgery while identifying missing preparation or risks early. |
| Support hydration and prescribed management of constipation or diarrhoea; record stool frequency and consistency. | Optimises bowel function and helps the team plan postoperative stool management. |
| Provide skin care after mucus or stool leakage; cleanse gently, dry without rubbing and apply a barrier product if ordered. | Prevents moisture-associated skin damage and reduces discomfort. |
| Discuss the planned procedure, expected pain control, mobilisation, diet, possible temporary urinary catheter and bowel regimen within the nurse’s scope; refer questions about surgical choices to the surgeon. | Improves readiness and helps the patient participate in recovery without providing misleading guarantees. |
| Address embarrassment, continence-related distress and family support with sensitivity; include a caregiver only with the patient’s agreement. | Promotes trust, appropriate support and realistic planning for recovery at home. |
Postoperative care depends on whether the patient has had an abdominal or perineal procedure, whether bowel resection or an anastomosis was performed, and the patient’s comorbidities. Follow the surgeon’s orders and the facility’s colorectal recovery protocol.
| Nursing action | Rationale |
|---|---|
| Monitor airway, breathing, circulation, consciousness, temperature, pain, fluid balance and urine output after anaesthesia. | Allows early recognition of anaesthetic complications, bleeding, dehydration, urinary retention or deterioration. |
| Inspect abdominal or perineal wounds and dressings; report increasing bleeding, redness, swelling, discharge, separation or offensive odour. | Supports early identification of haemorrhage or wound infection. |
| Assess abdominal pain, distension, nausea, vomiting, bowel sounds and passage of flatus or stool as appropriate; report worsening or unexpected findings. | May detect ileus, bowel obstruction, intra-abdominal complications or anastomotic problems. |
| Administer prescribed analgesia and reassess pain, sedation, respiratory status and response. | Comfort improves breathing, mobility and participation in recovery; opioid-related constipation and sedation also need monitoring. |
| Encourage early, progressive mobilisation and breathing exercises as allowed; apply prescribed venous thromboembolism prevention. | Reduces immobility-related pulmonary and thrombotic risks. |
| Advance oral fluids and diet according to the surgical plan; monitor nausea, hydration and tolerance. | Supports recovery while avoiding premature feeding if complications or specific orders require delay. |
| Follow the prescribed bowel regimen; encourage adequate fluids and fibre when appropriate, and administer stool softeners or laxatives only as ordered. | Soft stool and reduced straining help protect the repair and improve comfort. |
| Monitor urinary function after catheter removal and report inability to void, suprapubic discomfort or reduced output. | Pelvic surgery, anaesthesia and analgesics can contribute to urinary retention. |
| Provide gentle perineal hygiene, keep the area clean and dry, and teach wound care before discharge. | Protects delicate tissue and supports infection prevention and comfort. |
| Ask about first bowel movement, continence, urgency and fear of defecation; provide reassurance and escalate persistent or severe dysfunction. | Functional recovery can take time; early discussion helps the team adjust the plan and avoid straining. |
| Document observations, intake/output, bowel function, wound condition, education and escalation with time and response. | Clear documentation supports continuity and timely clinical decisions. |
| Possible nursing diagnosis | Expected outcome | Key nursing interventions |
|---|---|---|
| Acute pain related to tissue swelling, prolapse or surgical incision | Patient reports pain at an acceptable level and can rest, mobilise and participate in care | Assess pain and associated symptoms; position for comfort; administer prescribed analgesia; reassess effect; report severe escalating pain or pain with compromised tissue. |
| Impaired skin integrity related to mucus, stool leakage or moisture | Perianal and wound skin remain clean, dry and free from worsening excoriation | Inspect skin; cleanse gently after soiling; dry carefully; use prescribed barrier protection; manage leakage and report breakdown or infection. |
| Constipation or impaired bowel elimination related to straining, pelvic floor dysfunction or postoperative changes | Patient passes soft stool without excessive straining and understands the bowel plan | Record stool pattern; encourage ordered fluids, diet and mobility; administer prescribed bowel medicines; teach regular toileting and prompt reporting of obstruction symptoms. |
| Disturbed body image or social isolation related to prolapse, mucus or incontinence | Patient expresses concerns and identifies practical support for daily activities | Use respectful, non-stigmatising language; invite questions; maintain privacy; support continence and skin care; involve a counsellor or caregiver with consent. |
| Deficient knowledge related to diagnosis, surgery or home care | Patient or caregiver explains warning signs, wound care, bowel regimen and follow-up plan | Teach in short steps, demonstrate relevant care, use teach-back and provide written instructions in an understandable language. |
| Risk for infection related to surgery or compromised prolapsed tissue | Patient remains free of systemic or local signs of infection | Use hand hygiene and aseptic wound care; monitor temperature and wound; administer prescribed treatment; promptly report fever, purulent drainage or deterioration. |
| Complication | How it develops or presents | Nursing response |
|---|---|---|
| Incarceration and strangulation | Prolapse is trapped; oedema and vascular compromise may lead to ischaemia or necrosis | Emergency surgical escalation, close observations, tissue protection and preparation for urgent management |
| Ulceration and bleeding | Repeated friction and exposure inflame the mucosa and can cause sores or blood loss | Assess bleeding and haemodynamic status; protect tissue; report persistent or significant bleeding |
| Faecal incontinence | Sphincter stretch or pelvic nerve dysfunction reduces control of gas or stool | Assess impact, protect skin, support continence aids and refer for planned review |
| Constipation or obstructed defecation | Prolapse or associated pelvic floor dysfunction interferes with evacuation; postoperative constipation can also occur | Monitor bowel function and follow the individualised stool-softening plan; report vomiting, distension or failure to pass stool/flatus |
| Perianal skin excoriation and infection | Persistent mucus or faecal soiling damages skin and may permit infection | Provide gentle cleansing and barrier care; monitor for erythema, breakdown and discharge |
| Recurrence after repair | Prolapse can return; risk varies by procedure, patient factors and follow-up | Reinforce follow-up and avoidance of straining; report recurrent protrusion or new bowel symptoms |
| Postoperative complications | May include wound infection, bleeding, ileus, urinary retention, anastomotic leak, new or worsened constipation, or pelvic/sexual dysfunction | Monitor for clinical change and escalate early; provide non-judgmental support and appropriate referral |
- Keep follow-up appointments, even when the prolapse seems improved; review is needed to assess bowel function and recurrence.
- Follow the clinician’s individual plan for fluids, fibre, stool softeners or laxatives. Do not start or stop bowel medicines without advice, especially soon after surgery.
- Avoid prolonged straining and sitting on the toilet for a long time. Respond to the urge to defecate and use the toileting position recommended by the care team.
- Manage chronic constipation, diarrhoea, cough and mobility problems with the healthcare team; these may add repeated pressure or make bowel care difficult.
- Clean the perianal area gently after mucus or stool leakage, pat dry and use recommended skin protection. Seek help for increasing pain, broken skin, pus or fever.
- After surgery, increase activity gradually and follow instructions on lifting, diet, wound care, driving, work and sexual activity. These timelines vary by procedure and recovery.
- Seek urgent care if tissue becomes stuck outside, very painful, dark, increasingly swollen or heavily bleeding, or if there is fever, vomiting, abdominal distension, faintness, or inability to pass stool or gas.
- Explain that rectal prolapse is a medical condition and is not a reason for shame. Encourage the patient to discuss leakage, continence or emotional distress with the care team.
In children, rectal prolapse may be associated with straining, diarrhoea, constipation, malnutrition or other underlying illness. The child needs assessment to identify and treat the cause, with attention to hydration, nutrition, stool pattern, growth and perianal skin. Conservative bowel management is commonly considered first, but persistent, recurrent, painful or complicated prolapse requires specialist review. Provide reassurance to the child and caregiver, protect privacy and avoid blaming the child for symptoms.
Many patients improve after appropriate repair, but outcomes depend on sphincter function, the duration and type of prolapse, bowel habits, comorbid illness and the operation performed. Repair restores anatomy, but constipation, urgency or incontinence may persist or change; constipation can also newly develop or worsen after some abdominal procedures. Recovery of bowel function may take time. Follow-up should review wound healing, pain, continence, stool pattern, medication effects, nutrition, activity and any recurrent prolapse.
- Define full-thickness external rectal prolapse and distinguish it from internal intussusception.
- List five symptoms or signs that should be assessed in a patient with rectal prolapse.
- What features suggest an incarcerated or strangulated prolapse, and what are the immediate nursing priorities?
- Give four differences or assessment clues that help distinguish rectal prolapse from haemorrhoids.
- Name three investigations that may be selected before surgery and state the purpose of each.
- Compare an abdominal rectopexy with a perineal repair.
- State six nursing actions after rectal prolapse surgery and give a rationale for each.
- What education helps reduce straining and protect the repair at home?
- External full-thickness rectal prolapse is descent of the rectal wall through the anus; internal intussusception does not protrude externally.
- Haemorrhoids and rectal prolapse can look similar to patients, so appropriate clinical assessment is essential.
- Constipation and straining are common, but diarrhoea, pelvic floor dysfunction and other conditions may also contribute.
- Dark, swollen, painful or irreducible prolapse is an emergency; urgent surgical assessment takes priority.
- Bowel management supports comfort and recovery, while established external full-thickness prolapse usually needs surgical repair.
- Nursing care includes dignity, careful assessment, tissue and skin protection, bowel management, postoperative monitoring and clear return precautions.
- American Society of Colon and Rectal Surgeons (ASCRS). Rectal Prolapse. Patient information. https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse
- Bordeianou L, Paquette I, Johnson E, et al. Clinical Practice Guidelines for the Treatment of Rectal Prolapse. Diseases of the Colon & Rectum. 2017;60(11):1121–1131. PubMed record.
- WSES-AAST. Anorectal emergencies: WSES-AAST guidelines. World Journal of Emergency Surgery. 2021. Full guideline.
- Elagili F, et al. Evaluation, Diagnosis, and Medical Management of Rectal Prolapse. Clinics in Colon and Rectal Surgery. Full text.