Rectal prolapse in young adults.

Electromyographic studies in young adults with rectal prolapse have shown that there are a group of persons who cannot pull their prolapses in who have got very abnormal electromyograms. If this group are treated with major pelvic floor surgery the electromyogram appears to return to almost normal in two years. There are other young adults with rectal prolapse who can pull the prolapse in by contracting their own pelvic floors whose electromyograms approximate more closely to the normal. This latter group were treated with the insertion of circumanal nylon. It seems possible to differentiate the two groups without using electromyography on the basis of whether or not they can pull in the prolapse by contracting the pelvic floor and therefore the selection between patients for major surgery and minor surgery can be a clinical one. Further it would seem that as an initial operation, even the patients who are in the bad group can be treated by good bowel training and in a lesser operation, that if the bowel is kept in, the electromyograph returns to normal and hopefully in some of the patients major surgery is avoided.