Rectal prolapse: correction

• Rectal prolapse is a condition where the rectal mucosa prolapses outside of the rectum and anus.
• Most commonly associated with conditions that cause excessive straining. These conditions can be divided in to the following:
  • Tenesmus associated with coccidiosis and colitis.
  • Dysuria associated with cystitis, urolithiasis, dystocia and neoplasia.
  • Neuropathies associated with cows being mounted during estrus, spinal lymphoma, spinal abscesses and other spinal related conditions.
  • Chronic coughing from respiratory disease.
  • Genetic.
  • Dietary (feedstuffs high in estrogenic compounds).
  • Over conditioned cows with excess pelvic fat deposition.
• Rectal prolapses can be divided in to 4 categories:
  • Grade 1 – Prolapse of the rectal mucosa only (may be intermittent).
  • Grade II – Complete prolapse of all layers of the rectum (may be intermittent).
  • Grade III – Grade II rectal prolapse with intussusception of the large colon.
  • Grade IV – Grade III rectal prolapse and the anal sphincter is causing constriction of the rectum and colon.
• Grade I to II rectal prolapses are generally easily manually replaced and do not require surgical resection.
• Grade III and IV generally require surgical resection and correction.

Technical problems

• Surgical management of Grade III and Grade IV rectal prolapses, can be complicated by the level of compromized tissue, as a result of ischemic injury.

Time required

Preparation

• 15 minutes.

Procedure

• 30 minutes to 90 minutes (dependant on clinician experience).

Decision taking

Criteria for choosing test

• Grading of the rectal prolapse and the identification of the underlying condition will determine the approach to managing the animal.
• Grade I and II rectal prolapses are generally managed through lubrication and gentle manipulation of prolapse back into the body and placement of a purse-string suture.
• Grade III and IV rectal prolapses are generally managed by surgical intervention.