Prolapse of Rectum Caused by Vesical Calculus

A middle aged labourer was admitted into hospital for prolapse of the rectum about 4 inches in length, with discharge of mucus, tenesmus and incontinence of urine for the past li years. His main complaint was the continuous dribbling of urine. A tentative diagnosis of chronic bacillary dysentery, which had caused the rectal prolapse, and a reflex irritation of the bladder causing incontinence was made. Prolapse was easily reduced and rectal lavage with warm saline was given. The prolapse recurred as easily as it was reduced. Rectal lavage and rest having produced no effect, the bladder was examined with metal sounds and a fairly large vesical calculus was sounded. A rubber catheter could not be introduced for bladder washing. Any ^ttempt at introducing irrigating fluid into the bladder immediately produced an involuntary straining and rectal prolapse. Rectal examination was very difficult, due to reflex straining.