Rectal prolapse repair
Rectal prolapse repair is surgery to fix a rectal prolapse. This is a condition in which the last part of the intestine (called the rectum) sticks out through the anus.
Rectal prolapse surgery; Anal prolapse surgery
Rectal prolapse may be partial, involving only the inner lining of the bowel (mucosa). Or, it may be complete, involving the entire wall of the rectum.
For most adults, surgery is used to repair the rectum because there is no other effective treatment.
Children with rectal prolapse do not always need surgery, unless their prolapse does not improve over time. In infants, prolapse often disappears without treatment.
There are three basic types of surgery to repair rectal prolapse. Your surgeon will decide which one is best for you.
For healthy adults, an abdominal procedure has the best chance of success. While you are under general anesthesia, the doctor makes a surgical cut in the abdomen and removes a portion of the colon. The rectum may be attached (sutured) to the surrounding tissue so it will not slide and fall out through the anus. Sometimes, a soft piece of mesh is wrapped around the rectum to help it stay in place. These procedures can also be done with laparoscopic surgery (also known as keyhole or telescopic surgery).
For older adults or those with other medical problems, an approach through the anus (perineal approach) might be less risky. It might also cause less pain and lead to a shorter recovery. But with this approach, the prolapse is more likely to come back (recur).
One of the surgical repairs through the anus involves removing the prolapsed rectum and colon and then suturing the rectum to the surrounding tissues. This procedure can be done under general, epidural, or spinal anesthesia.
Very frail or sick people may need a smaller procedure that reinforces the sphincter muscles. This technique encircles the muscles with a band of soft mesh or a silicone tube. This approach provides only short-term improvement and is rarely used.
Risks of anesthesia and surgery in general include:
Risks of this surgery include:
Before the Procedure
During the 2 weeks before your surgery:
The day before your surgery:
On the day of your surgery:
After the Procedure
How long you stay in the hospital depends on the procedure. For open abdominal procedures it may be 5 to 8 days. You will go home sooner if you had laparoscopic surgery. The stay for perineal surgery may be 2 to 3 days.
You should make a complete recovery in 4 to 6 weeks.
The surgery usually works well at repairing the prolapse. Constipation and incontinence can be problems for some people.
Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 51.
Pidala MJ. Rectal prolapse. In: Bailey HR, Billingham RP, Stamos MJ, Snyder MJ, eds. Colorectal Surgery. Philadelphia, PA: Elsevier Saunders; 2013:chap 30.
Review Date: 1/7/2018
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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