What is Rectal Prolapse Surgery? Purpose, Procedure & Recovery

Rectal prolapse surgery is a medical procedure that repairs a condition where part of your rectum slides out through your anus. This happens when the muscles and tissues that normally hold your rectum in place become weakened or stretched. While it sounds alarming, this condition is treatable, and surgery can restore normal function and significantly improve your quality of life.

What is rectal prolapse?

Rectal prolapse occurs when the rectum (the last part of your large intestine) loses its normal support and slips down through the anal opening. Think of it like a sock that has turned inside out. The rectum may slide out just a little bit or protrude several inches outside your body.

This condition affects people of all ages, though it's more common in older adults, particularly women over 50. Children can also develop rectal prolapse, but it often resolves on its own as they grow. The condition isn't dangerous, but it can be uncomfortable and affect your daily activities.

There are different types of rectal prolapse. Complete prolapse means the entire thickness of the rectal wall comes out through the anus. Partial prolapse involves only the inner lining of the rectum. Some people experience internal prolapse, where the rectum telescopes inside itself but doesn't come out of the anus.

Why is rectal prolapse surgery done?

Surgery becomes necessary when rectal prolapse significantly impacts your daily life or causes complications. Your doctor will recommend surgery if the prolapse doesn't go back in on its own, causes pain, or leads to problems with bowel movements.

The main reasons for surgery include persistent discomfort, difficulty controlling bowel movements, bleeding from the protruding tissue, or when the prolapse becomes trapped and can't be pushed back in. Some people also choose surgery because the condition affects their confidence and ability to participate in normal activities.

Non-surgical treatments like pelvic floor exercises, dietary changes, or stool softeners might be tried first, especially for mild cases. However, these approaches rarely provide a permanent solution for complete rectal prolapse. Surgery offers the most reliable way to fix the problem and prevent it from coming back.

What is the procedure for rectal prolapse surgery?

Rectal prolapse surgery can be performed through two main approaches: through your abdomen or through the area around your anus. Your surgeon will choose the best method based on your age, overall health, and the severity of your prolapse.

During abdominal surgery, your surgeon makes small incisions in your belly and uses special instruments to lift and secure your rectum back into its proper position. This approach often involves laparoscopic techniques, which use tiny cameras and tools inserted through small cuts. The surgeon may attach your rectum to the backbone area or remove a section of colon if it's too long.

The perineal approach involves working through the area around your anus without making cuts in your abdomen. This method is often chosen for older patients or those with other health conditions that make abdominal surgery riskier. The surgeon removes the protruding tissue and strengthens the muscles around the anus.

Most rectal prolapse surgeries take between one to three hours. You'll receive general anesthesia, which means you'll be completely asleep during the procedure. The specific technique your surgeon uses depends on factors like your anatomy, the type of prolapse, and your individual health needs.

How to prepare for your rectal prolapse surgery?

Preparing for rectal prolapse surgery involves several important steps that help ensure the best possible outcome. Your surgeon will provide specific instructions, but preparation typically begins a few days before your procedure.

Your doctor will likely ask you to clean out your bowel before surgery using a special solution or enemas. This step is crucial because it reduces the risk of infection and gives your surgeon a clear view of the surgical area. You'll also need to stop eating and drinking for a certain period before surgery, usually starting at midnight the night before.

Let your healthcare team know about all medications you're taking, including over-the-counter drugs and supplements. Some medications, particularly blood thinners, may need to be stopped or adjusted before surgery. Your doctor might also recommend stopping certain supplements that can affect bleeding.

Arrange for someone to drive you home after surgery and stay with you for the first day or two. Stock up on soft, easy-to-digest foods and any supplies your doctor recommends for recovery. Having everything ready beforehand will help you focus on healing after your procedure.

How to read your rectal prolapse surgery results?

Success after rectal prolapse surgery is measured by how well the procedure resolves your symptoms and prevents the prolapse from returning. Most people experience significant improvement in their quality of life within a few weeks to months after surgery.

Your surgeon will monitor your recovery through follow-up appointments, typically scheduled a few weeks after surgery, then at longer intervals. During these visits, your doctor will check that the surgical site is healing properly and that you're not experiencing complications.

Signs of successful surgery include the ability to have normal bowel movements, relief from pain or discomfort, and no visible prolapse. Your doctor will also assess whether you've regained normal control over your bowel movements, though this improvement may take several months.

Some people experience temporary changes in bowel habits after surgery, such as more frequent bowel movements or changes in stool consistency. These effects usually improve as your body heals. Your healthcare team will help you understand what's normal during recovery and when to seek additional care.

What are the risk factors for rectal prolapse?

Understanding the risk factors for rectal prolapse can help you recognize why this condition develops and who might be more likely to experience it. While anyone can develop rectal prolapse, certain factors increase your chances.

Age is one of the most significant risk factors, with the condition being much more common in people over 50. Women are affected more often than men, particularly those who have had multiple pregnancies or difficult deliveries. The stretching and weakening of pelvic muscles during childbirth can contribute to prolapse later in life.

Chronic constipation and straining during bowel movements put extra pressure on the rectum and can weaken the supporting tissues over time. Conditions that cause persistent coughing, such as chronic lung disease, can also increase pressure in the abdomen and contribute to prolapse development.

Other risk factors include having had previous pelvic surgery, certain genetic conditions that affect connective tissue, and neurological problems that affect the nerves controlling the rectum. Some people are born with weaker connective tissues that make them more susceptible to prolapse throughout their lives.

What are the possible complications of rectal prolapse surgery?

While rectal prolapse surgery is generally safe and effective, like any surgical procedure, it carries some risks. Understanding these potential complications can help you make an informed decision and know what to watch for during recovery.

Common complications that can occur after surgery include bleeding, infection at the surgical site, and temporary difficulty with bowel movements. Some people experience changes in their bowel habits, such as increased urgency or frequency, which usually improve over time as the body adjusts.

More serious but less common complications can include injury to nearby organs, such as the bladder, blood vessels, or nerves. In rare cases, the prolapse may return, requiring additional surgery. Some people develop adhesions (scar tissue) that can cause intestinal blockages, though this is uncommon.

Sexual function problems can occasionally occur, particularly with abdominal approaches to surgery, due to potential nerve damage. However, skilled surgeons take great care to protect these important nerves during the procedure. Most people recover fully without any lasting complications.

Your surgical team will monitor you closely during recovery and provide clear instructions about warning signs to watch for. Seeking prompt medical attention for any concerning symptoms can help prevent minor issues from becoming serious problems.

When should I see a doctor for rectal prolapse?

You should see a doctor if you notice any tissue protruding from your anus, especially if it doesn't go back in on its own or causes pain. Early evaluation and treatment can prevent the condition from worsening and improve your long-term outcomes.

Schedule an appointment if you experience persistent changes in your bowel habits, such as difficulty controlling bowel movements, bleeding during or after bowel movements, or a feeling that you can't completely empty your bowel. These symptoms might indicate rectal prolapse or another condition that needs medical attention.

Seek immediate medical care if you have severe pain, excessive bleeding, or if prolapsed tissue becomes dark, cold, or very painful. These signs might indicate that the blood supply to the tissue is compromised, which requires urgent treatment to prevent serious complications.

Don't feel embarrassed about discussing these symptoms with your healthcare provider. Rectal prolapse is a common medical condition, and your doctor has the training and experience to help you feel comfortable while addressing your concerns effectively.