ABSTRACT
Rectal prolapse has been recognized since antiquity. The first description of this condition can be found in the Ebers Papyrus from 1500 B.C. (1). Through the ensuing centuries, understanding of rectal prolapse focused on the perineum, and therapy was designed to hide the prolapse, tighten the anus, or scar the rectum to prevent protrusion (2). Modern understanding of the pathophysiology and treatment of prolapse began with Moschowitz’s description in 1912. Moschowitz emphasized the abdominal component of prolapse and its similarity to other abdominal wall hernias. The repair that bears his name is based upon these principles (3). Since 1912, our understanding of rectal prolapse has improved. Preoperative evaluation now includes anorectal physiology testing and evaluation of bowel function. Dozens of surgical approaches have been described with variable success. Finally, evaluation of postoperative success has shifted to include not only anatomic recurrence, but also assessment of function.
ANATOMY AND PATHOPHYSIOLOGY
