Anorectal prolapse

Metadata

Name	Anorectal prolapse (anorectal_prolapse)
Category	Digestive
Sex
Adult	Yes
UUID	01bc7f8b-eb06-4cf4-b899-6b08a55fdec5
Definition	Protrusion of the rectal mucous membrane through the anus. There are various degrees: incomplete with no displacement of the anal sphincter muscle; complete with displacement of the anal sphincter muscle; complete with no displacement of the anal sphincter muscle but with herniation of the bowel; and internal complete with rectosigmoid or upper rectum intussusception into the lower rectum.

Ontologies

Disease Ontology (DOID)	DOID_9307
GWAS Catalogue	MONDO_0004754
MeSH	D012005
SNOMED-CT	57773001

Key Summary Statistics

Cases from any source

Total	2876
Female (%)	2222 (77%)
Male (%)	654 (23%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	39.37 (35.16,43.59)
Male	14.42 (11.64,17.2)

Incidence stratified by sex

Female	4.57 (4.02,5.13)
Male	1.71 (1.34,2.08)

Incidence stratified by age

Ages 40-44	1.51 (0.75,2.27)
Ages 45-49	2.08 (1.31,2.85)
Ages 50-54	2.03 (1.33,2.73)
Ages 55-59	3.18 (2.38,3.98)
Ages 60-64	4.39 (3.59,5.2)
Ages 65-69	4.54 (3.6,5.48)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	20 (16,24)	37 (33,42)	57 (52,62)
CALIBER	19 (18,21)	30 (29,32)	54 (52,56)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	20(11,33)	32(23,43)	56(46,67)
Low	18(10,31)	41(31,53)	53(44,64)
Medium	22(13,35)	30(22,41)	50(41,61)
High	16(9,27)	42(32,54)	62(51,75)
Most deprived	20(12,31)	43(33,55)	64(52,77)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	19(15,24)	37(32,42)	56(51,62)
Scotland	16(7,30)	36(25,51)	62(48,78)
Wales	34(17,61)	44(28,65)	55(39,75)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=154022, Events=131

Factor	Level	Hazard Ratio	P value
BMI	overweight	1.27 (0.78, 2.07)	0.333
BMI	obese	2.62 (1.63, 4.22)	6.84e-05
BMI	underweight	0 (0, Inf)	0.992
smoking	previous	1.3 (0.9, 1.9)	0.166
smoking	current	1.71 (0.99, 2.95)	0.0544
hypertension	yes	1.97 (1.38, 2.82)	0.000171

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1603	rectal prolapse
41202	Diagnoses - main ICD10	K62.2	Anal prolapse
41202	Diagnoses - main ICD10	K62.3	Rectal prolapse
41204	Diagnoses - secondary ICD10	K62.2	Anal prolapse
41204	Diagnoses - secondary ICD10	K62.3	Rectal prolapse
41200	Operative procedures - main OPCS4	H36	Other abdominal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H36.1	Abdominal repair of levator ani muscles
41200	Operative procedures - main OPCS4	H36.8	Other specified other abdominal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H36.9	Unspecified other abdominal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H42	Perineal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H42.1	Insertion of encircling suture around perianal sphincter
41200	Operative procedures - main OPCS4	H42.2	Perineal plication of levator ani muscles and anal sphincters
41200	Operative procedures - main OPCS4	H42.3	Insertion of supralevator sling
41200	Operative procedures - main OPCS4	H42.4	Removal of encircling suture from around perianal sphincter
41200	Operative procedures - main OPCS4	H42.5	Excision of mucosal prolapse of rectum NEC
41200	Operative procedures - main OPCS4	H42.6	Perineal repair of prolapse of rectum NEC
41200	Operative procedures - main OPCS4	H42.8	Other specified perineal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H42.9	Unspecified perineal operations for prolapse of rectum
41200	Operative procedures - main OPCS4	H44.2	Manual reduction of prolapse of rectum
41210	Operative procedures - secondary OPCS4	H36	H36
41210	Operative procedures - secondary OPCS4	H36.1	H36.1
41210	Operative procedures - secondary OPCS4	H36.8	H36.8
41210	Operative procedures - secondary OPCS4	H36.9	H36.9
41210	Operative procedures - secondary OPCS4	H42	H42
41210	Operative procedures - secondary OPCS4	H42.1	H42.1
41210	Operative procedures - secondary OPCS4	H42.2	H42.2
41210	Operative procedures - secondary OPCS4	H42.3	H42.3
41210	Operative procedures - secondary OPCS4	H42.4	H42.4
41210	Operative procedures - secondary OPCS4	H42.5	H42.5
41210	Operative procedures - secondary OPCS4	H42.6	H42.6
41210	Operative procedures - secondary OPCS4	H42.8	H42.8
41210	Operative procedures - secondary OPCS4	H42.9	H42.9
41210	Operative procedures - secondary OPCS4	H44.2	H44.2
40001	Underlying (primary) cause of death: ICD10	K62.2	Anal prolapse
40001	Underlying (primary) cause of death: ICD10	K62.3	Rectal prolapse
40002	Contributory (secondary) causes of death: ICD10	K62.2	Anal prolapse
40002	Contributory (secondary) causes of death: ICD10	K62.3	Rectal prolapse
42040	GP clinical event records	7720.00	Partial excision of rectum and sigmoid colon for prolapse
42040	GP clinical event records	7720y00	Partial excision of rectum and sigmoid colon for prolapse OS
42040	GP clinical event records	7720z00	Partial excision of rectum & sigmoid colon for prolapse NOS
42040	GP clinical event records	7723400.0	Proctopexy for prolapse of rectum
42040	GP clinical event records	7723411.0	Erickman repair of prolapse of rectum
42040	GP clinical event records	7723500.0	Insertion of sponge for rectal prolapse
42040	GP clinical event records	7723511.0	Insertion of Wells sponge for rectal prolapse
42040	GP clinical event records	7723.00	Fixation of rectum for prolapse
42040	GP clinical event records	7723.11	Proctopexy for prolapse of rectum
42040	GP clinical event records	7723.12	Rectopexy for prolapse
42040	GP clinical event records	7723y00	Other specified fixation of rectum for prolapse
42040	GP clinical event records	7723z00	Fixation of rectum for prolapse NOS
42040	GP clinical event records	7724011.0	Graham repair for rectal prolapse
42040	GP clinical event records	7724012.0	Roscoe repair for rectal prolapse
42040	GP clinical event records	7724.00	Other abdominal operations for rectal prolapse
42040	GP clinical event records	7724y00	Other abdominal operation for rectal prolapse OS
42040	GP clinical event records	7724y11	Delorme repair of rectum for prolapse
42040	GP clinical event records	7724z00	Other abdominal operation for rectal prolapse NOS
42040	GP clinical event records	7726400.0	Reduction of prolapsed rectum NEC
42040	GP clinical event records	7727011.0	Thiersch wiring for prolapse of rectum
42040	GP clinical event records	7727400.0	Excision of mucosal prolapse of rectum NEC
42040	GP clinical event records	7727500.0	Perineal repair of rectal prolapse NEC
42040	GP clinical event records	7727.00	Perineal operations for rectal prolapse
42040	GP clinical event records	7727y00	Other specified perineal operation for rectal prolapse
42040	GP clinical event records	7727z00	Perineal operation for rectal prolapse NOS
42040	GP clinical event records	7728400.0	Manual reduction of rectal prolapse
42040	GP clinical event records	J571000	Partial rectal prolapse
42040	GP clinical event records	J571100	Complete rectal prolapse
42040	GP clinical event records	J571200	Anal prolapse
42040	GP clinical event records	J571.00	Rectal prolapse
42040	GP clinical event records	J571.11	Procidentia - anus and/or rectum
42040	GP clinical event records	J571.12	Proctoptosis
42040	GP clinical event records	J571z00	Rectal prolapse NOS
42040	GP clinical event records	J579.00	Rectal mucosa prolapse
42040	GP clinical event records	XE0Dk	Other specified other abdominal operation for rectal prolapse
42040	GP clinical event records	XE0Dj	Abdominal repair of levator ani muscles
42040	GP clinical event records	XaMym	Rectal mucosa prolapse
42040	GP clinical event records	XaQbP	Anal prolapse
42040	GP clinical event records	XE0Dh	Proctopexy for prolapse of rectum