Subscribe to RSS
DOI: 10.1055/s-0045-1804512
History of the Treatment of Rectal Prolapse

Abstract
Rectal prolapse is the intussusception of the rectum, resulting in its full-thickness protrusion out of the anus. Approximately 0.5% of the general population is affected by this condition, with a higher occurrence in women and the elderly. While benign, rectal prolapse can be debilitating, as it can cause pain, bleeding, mucus discharge, and fecal incontinence. The earliest documented records of rectal prolapse date back to Ancient Egypt (1500–1200 BC), describing laxatives and topical therapeutics for the treatment of an anus turned inside out. Many techniques were devised to hold the reduced prolapsed rectum in place, ranging from cords to the use of bandages. Surgical cauterization of the anal sphincter to prevent recurrent prolapse began as early as 6 BC in India, a practice that continued into the 1800s. Advances in fundamental understanding of the anatomy of the colon, rectum, and anus in the 19th and early 20th centuries paved the way for modern surgical approaches. The 20th century saw the development of procedures proposed by surgeons such as Delorme, Moschowitz, Ripstein, and Altemeier. The emergence of the laparoscopic rectopexy in 1992 and subsequent use of robotic-assisted techniques in the early 2000s marked the transition to modern rectal prolapse surgeries, improving both precision and outcomes. The overall management of rectal prolapse has evolved significantly from ancient remedies to the surgeries known today, yet some fundamental similarities remain consistent between today's outlook and what was documented centuries ago. Understanding the historical evolution of the diagnosis and treatment of rectal prolapse provides insight into the contemporary management of the disorder.
Keywords
rectal prolapse - rectopexy - history of surgery - suture rectopexy - ventral mesh rectopexyPublication History
Article published online:
25 February 2025
© 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Bordeianou L, Paquette I, Johnson E. et al. Clinical practice guidelines for the treatment of rectal prolapse. Dis Colon Rectum 2017; 60 (11) 1121-1131
- 2 Neshatian L, Lee A, Trickey AW, Arnow KD, Gurland BH. Rectal prolapse: age-related differences in clinical presentation and what bothers women most. Dis Colon Rectum 2021; 64 (05) 609-616
- 3 Chaudhry V, Abcarian H. Complete rectal prolapse. In: Shackelford's Surgery of the Alimentary Tract. 2013: 1824-1832
- 4 Graney MJ, Graney CM. Colorectal surgery from antiguity to the modern era. Dis Colon Rectum 1980; 23 (06) 432-441
- 5 Banov Jr L. The Chester Beatty Medical Papyrus: the earliest known treatise completely devoted to anorectal diseases. Surgery 1965; 58 (06) 1037-1043
- 6 Sefaria.org. Kings II. 2023. Accessed November 1, 2024 at: https://www.sefaria.org/II_Kings.1.1?lang=bi
- 7 Tsoucalas G, Papaioannou TG, Papatheodoridis GV, Karamanou M. Hippocratic views in the treatment of rectal prolapse. Acta Gastroenterol Belg 2017; 80 (03) 411-415
- 8 Babylonian Medical Text. The Schoyen Collection. Accessed November 19, 2024 at: https://www.schoyencollection.com/24-smaller-collections/medical-texts/babylonian-medical-text-ms-4575
- 9 Singhal GD, Singh LM, Siṃha KP. Suśruta. Diagnostic Considerations in Ancient Indian Surgery: Based on Nidāna-Sthāna of Susruta-Saṁhitā. G.D. Singhal; 1972
- 10 The Ecclesiastical History of Socrates, Surnamed Scholasticus, or the Advocate Comprising a History of the Church, in Seven Books. London: Henry G. Bohn; 1853
- 11 Moodie RL. Paleopathology: An Introduction to the Study of Ancient Evidences of Disease. University of Illinois Press; 1923: 432 , plate 78c
- 12 Magrill D, Sekaran P. Maimonides: an early but accurate view on the treatment of haemorrhoids. Postgrad Med J 2007; 83 (979) 352-354
- 13 Maksimovic J, Maksimovic M. From history of proctology. Arch Oncol 2013; 21 (01) 28-33
- 14 Woodall J. The Surgions Mate. Edward Griffin; 1617: 245-247
- 15 Salmon F. Practical Observations on Prolapsus of the Rectum. Whittaker, Treacher and Arnot; 1831
- 16 Chelius JM. A System of Surgery. Renshaw; 1847
- 17 Kelsey CB. Diseases of the Rectum and Anus. W. Wood & Company; 1882
- 18 Verneuil. Prolapse of the rectum. Ann Surg 1891; 13: 218-219
- 19 Thiersch C. Carl Thiersch 1822-1895. Concerning prolapse of the rectum with special emphasis on the operation by Thiersch. Dis Colon Rectum 1988; 31 (02) 154-155
- 20 Delorme M. Classic articles in colonic and rectal surgery. Edmond Delorme 1847-1929. On the treatment of total prolapse of the rectum by excision of the rectal mucous membranes or recto-colic. Dis Colon Rectum 1985; 28 (07) 544-553
- 21 Moschcowitz AV. Classic articles in colonic and rectal surgery. Alexis Victor Moschcowitz, 1865-1937. The pathogenesis, anatomy, and cure of prolapse of the rectum. Dis Colon Rectum 1983; 26 (08) 553-565
- 22 Pennington JR, Banov L. A Treatise on the Diseases and Injuries of the Rectum, Anus and Pelvic Colon. P. Blakiston's Son & Co; 1923
- 23 Pemberton JD, Stalker LK. Surgical treatment of complete rectal prolapse. Ann Surg 1939; 109 (05) 799-808
- 24 Ripstein CB. Surgical care of massive rectal prolapse. Dis Colon Rectum 1965; 8 (01) 34-38
- 25 Muir EG. The surgical treatment of severe rectal prolapse. Proc R Soc Med 1959; 52 (Suppl. 01) 104-105
- 26 Wells C. New operation for rectal prolapse. Proc R Soc Med 1959; 52 (08) 602-603
- 27 Brodén B, Snellman B. Procidentia of the rectum studied with cineradiography. A contribution to the discussion of causative mechanism. Dis Colon Rectum 1968; 11 (05) 330-347
- 28 Theuerkauf Jr FJ, Beahrs OH, Hill JR. Rectal prolapse. Causation and surgical treatment. Ann Surg 1970; 171 (06) 819-835
- 29 Frykman HM, Goldberg SM. The surgical treatment of rectal procidentia. Surg Gynecol Obstet 1969; 129 (06) 1225-1230
- 30 Barfield LR. Perineal approaches to rectal prolapse. Clin Colon Rectal Surg 2017; 30 (01) 12-15
- 31 Joubert K, Laryea JA. Abdominal approaches to rectal prolapse. Clin Colon Rectal Surg 2017; 30 (01) 57-62
- 32 Kellokumpu IH, Vironen J, Scheinin T. Laparoscopic repair of rectal prolapse: a prospective study evaluating surgical outcome and changes in symptoms and bowel function. Surg Endosc 2000; 14 (07) 634-640
- 33 Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg 2005; 140 (01) 63-73
- 34 Pugin F, Bucher P, Morel P. History of robotic surgery: from AESOP® and ZEUS® to da Vinci®. J Visc Surg 2011; 148 (5 suppl): e3-e8
- 35 Protyniak B, Jorden J, Farmer R. Multiquadrant robotic colorectal surgery: the da Vinci Xi vs Si comparison. J Robot Surg 2018; 12 (01) 67-74
- 36 Munz Y, Moorthy K, Kudchadkar R. et al. Robotic assisted rectopexy. Am J Surg 2004; 187 (01) 88-92
- 37 Loygue J, Nordlinger B, Cunci O, Malafosse M, Huguet C, Parc R. Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases. Dis Colon Rectum 1984; 27 (06) 356-359
- 38 D'Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 2004; 91 (11) 1500-1505
- 39 Gee AD, Lee SK, Ban K, Paraiso MFR. The Current Evidence and How-To on Combined Sacrocolpopexy and Rectopexy. Int Urogynecol J 2024; 35 (10) 1955-1960
- 40 Corman M. Classical articles in colonic and rectal surgery. Bulletin et memories de la Societe de Chirurgie de Paris. Séance du 9 Mai, 1900; 26:499–516. Translation by N McGill. Translation of the original work of Edmond Delorme from 1900.