Digestive Health More Digestive Diseases Understanding Rectal Prolapse Surgery By Jenny Lelwica Buttaccio, OTR/L Jenny Lelwica Buttaccio, OTR/L LinkedIn Twitter Jenny Lelwica Buttaccio, OTR/L, is a licensed occupational therapist and advocate for patients with Lyme disease. Learn about our editorial process Updated on July 24, 2022 Medically reviewed by Jennifer Schwartz, MD Medically reviewed by Jennifer Schwartz, MD Jennifer Schwartz, MD, is a board-certified surgeon and Assistant Professor of Surgery at the Yale School of Medicine. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Purpose Symptoms Risk Factors Preparation After Surgery Prognosis A rectopexy is often performed when there is a protrusion of the rectum through the anus known as a prolapse. In other words, the rectum, which is located at the end of your large intestine, ceases to be supported in its normal position in the body. It either falls or slides down through the anus. The procedure is also known as the rectal prolapse surgery. Although a prolapsed rectum isn’t life-threatening, it can certainly be life-altering as it causes a host of distressing symptoms. Over time, the condition can worsen. Rectal prolapse is considered uncommon, with approximately 2.5 reported cases in 100,000 people, according to the American Society of Colon and Rectal Surgeons (ASCRS). Rectal prolapse typically occurs six times more often in people assigned female at birth 50 years or older than in those assigned male at birth of the same age. However, anyone can have rectal prolapse regardless of their sex assigned at brith or age. Verywell / Nusha Ashjaee Purpose The main reason a healthcare provider will perform a rectopexy is to correct and repair the rectal prolapse so that it can function in a normal fashion. There are three primary types of rectal prolapse where surgery may be considered. These include the following instances: The rectum has fallen from its normal position, but it remains inside the anus.A portion of the rectum protrudes through the opening of the anus.The complete rectum has fallen outside the anus. The treatment for rectal prolapse depends on the severity of the condition and symptoms. When surgery is required, there are three types of approaches to consider. Three Types of Surgery for Rectal Prolapse Abdominal rectopexyLaparoscopic procedurePerineal approach The first, an abdominal rectopexy, aims to repair the prolapsed organ by entering the belly with one open incision. The second approach, a laparoscopic procedure, requires smaller incisions—the surgeon uses a camera and specially-designed surgical instruments to correct the rectal prolapse. The third type, a perineal approach, treats rectal prolapse by entering the region around the anus. All three procedures involve freeing the rectum from the tissues around it and repositioning it into its proper place using stitches. In some cases, mesh may be used to support the rectum and secure it in place. At the present time, there isn’t a consensus over which approach is best, as stated in an article from the Journal of Minimal Access Surgery. An abdominal operation, in general, is most often done as a laparoscopic procedure. This is thought to lead to better outcomes and a reduced risk of recurrence. The perineal approach may be used in cases where a person isn’t able to undergo an abdominal procedure. Symptoms However, to decide which surgery is right for you, a healthcare provider will need to consider factors like your age, other health conditions, and the best way to alleviate the symptoms. Symptoms which may warrant consideration for a rectopexy include: ConstipationLeaking of stool or fecal incontinenceRectal bleedingDrainage of mucusPain in the rectum or anusWeakness in the muscles that support the rectumOther changes in bowel habits Risk Factors A rectopexy isn’t a risk-free procedure—it can lead to serious complications. The risks may differ depending on the type of procedure that is used and an individual’s medical history. Those who are considered obese (body mass index over 30) are more likely to experience complications, and their healthcare provider may decide that one surgery is a safer approach than another. However, it’s important to note that most people make a successful recovery following the surgery. A general list of risks associated with this operation include: An infection Changes in bowel habits such as increased constipation or diarrhea Recurrence of the rectal prolapse Pain Bleeding A bowel obstruction Incontinence of the bowel Damage to organs, tissues, or nerves in the vicinity of the operation Development of a fistula Preparation The day before the operation, you may be asked to use a medication, like an enema or laxative, to flush out the bowel and any remaining fecal matter in preparation for the surgery. This process is known as mechanical bowel preparation. A healthcare provider might also ask you to shower using a soap that disinfects your skin to reduce the growth of microorganisms that could lead to infection. You may also be asked to stop your intake of food, drink, and certain medications the night prior to the surgery. In some cases, you might be able to take critical medications, but with a small amount of liquid. Additionally, you may receive intravenous (IV) antibiotics right before the procedure to further reduce your risk of infection. After Surgery You’ll need to stay in the hospital for at least a day so after the procedure so that the healthcare team can monitor your progress, watch for signs of infection, provide pain medication, and assess your bowel function. You might be asked to eat a special diet, which might consist of things like increasing your fluid intake and eating softened or fiber-rich foods to prevent constipation. When you leave the hospital and head home, you’ll be given a post-operative appointment to check your recovery. Typically, patients have recovered from a rectopexy within four to six weeks. Prognosis Most often, the surgery works to alleviate the symptoms of rectal prolapse. Rectal prolapse recurs in approximately 2 to 5% of those who’ve had the surgery. Additionally, for some people, there may be a change in bowel habits. For example, some patients may experience a new onset of constipation following the surgery. You’ll want to talk to a healthcare provider if any new symptoms arise so that you can discuss new ways to ease any discomfort. A Word From Verywell Once you leave the hospital, you’ll be provided instructions to gradually increase your activity level. You might be asked to walk in a low-impact way to use your muscles and increase circulation. If you have weak muscle tone in the pelvic floor muscle, which holds your rectum in place, a healthcare provider may want you to see a physical therapist. As with any procedure, if you have questions or concerns, be sure to talk with a practitioner so you can get back to your daily life. What Is a Prolapsed Hemorrhoid? Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Society of Colon and Rectal Surgeons. Rectal Prolapse Expanded Version. Bhandarkar DS. Laparoscopic rectopexy for complete rectal prolapse: mesh, no mesh or a ventral mesh? Journal of Minimal Access Surgery. 2014 Jan-Mar; 10(1): 1–3. doi:10.4103/0972-9941.124448 Cleveland Clinic. Laparoscopic Rectopexy. Mayo Clinic. Rectal Prolapse Surgery. Russell MM, Read TE, Roberts PL, Hall JF, Marcello PW, Schoetz DJ, Ricciardi R. Complications after rectal prolapse surgery: does approach matter? Diseases of the Colon and Rectum. 2012 Apr; 55(4): 450-8. doi:10.1097/DCR.0b013e31823f86b8 By Jenny Lelwica Buttaccio, OTR/L Jenny Lelwica Buttaccio, OTR/L, is a licensed occupational therapist and advocate for patients with Lyme disease. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! 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