Surgery for complete rectal prolapse

Surgeons can repair a complete rectal prolapse by making a cut through the abdomen or the perineum.

  • In abdominal surgery, the surgeon makes a cut in the abdomen. He or she may secure part of the large intestine or the rectum, or both, to the inside of the abdominal cavity with sutures or a piece of plastic mesh (rectopexy). This surgery can restore a natural shape to the large intestine. The surgeon may also remove part of the large intestine and sew the ends together. Other conditions that may be present (such as a rectocele or prolapsed uterus) can also be repaired. Depending on the type of problems present, the surgeon may make a large, single cut (open surgery) or may make several small cuts along with using an instrument with a small camera that allows the surgeon to see inside the body (laparoscopic surgery).
  • In perineal surgery, the surgeon goes through the perineum or anus. The surgeon can place a piece of mesh or suture material around the circular muscle that controls the anus (anal sphincter). This type of surgery does not stress the body as much as other types of surgery, but it is more likely that prolapse will occur again. It is most often used for frail, older adults who have other serious medical problems. It does not correct the condition that is causing the prolapse and can lead to problems with constipation or blockage. People who have this type of surgery may need frequent laxatives or enemas. Rectal prolapse will come back in about 3 to 5 out of every 10 people who have this surgery.1

The risk that rectal prolapse will recur is lower after abdominal surgery than after the perineal approach. However, abdominal surgery carries a higher risk of complications than perineal surgery and may not be a good choice for older people and those who have other health problems.2

If the surrounding tissue is no longer holding part of large intestine in the correct position, your surgeon may have to remove part of the intestine and then reattach it to the rectum. This surgery is often done through the anus.

Citations

  1. Dozois EJ, Pemberton JH (2006). Rectal prolapse and solitary rectal ulcer syndrome section of Hemorrhoids and other anorectal disorders. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 954–955. Philadelphia: Saunders Elsevier.
  2. Welton ML (2003). Abnormal rectal fixation section of Anorectal diseases. In SL Friedman et al., eds., Current Diagnosis and Treatment in Gastroenterology, 2nd ed., pp. 459–462. New York: McGraw Hill.

Last Updated: July 23, 2009

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