Adults with rectal prolapse need surgery to put rectal tissue that slips into their anus back where it belongs. Rectal prolapse surgery (rectopexy) may take place through your abdomen or perineum (a perineal rectosigmoidectomy). Without surgery, rectal prolapse can worsen fecal incontinence and lead to more serious issues.
Rectal prolapse surgery is a procedure that fixes rectal prolapse. In rectal prolapse, the end of your colon (rectum) starts to slide into your anus (butthole). This can happen as you age, during or after pregnancy, or after an injury or illness. It might feel like pressure or a bulge in your anus after you poop.
Rectal prolapse isn’t a medical emergency, but it gets worse over time if it isn’t fixed with rectal prolapse surgery. Your surgeon can put the tissue back where it belongs so you don’t develop pain, problems with pooping (incontinence or constipation) or other serious complications.
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Rectal prolapse isn’t common. It only occurs in about 0.5% of people. The condition affects people of all ages, including children. But it’s more common in people over 50 and those assigned female at birth (AFAB). Without surgery, rectal prolapse in adults gets worse and can lead to serious complications.
This isn’t usually the case with children. Kids often develop rectal prolapse after having chronic constipation, diarrhea or a parasitic infectious disease. With time and the proper treatments for the underlying cause, the muscles that support your child’s rectum heal and get strong enough to hold their rectum in place. It’s rare for a child with rectal prolapse to need surgery.
Rectal prolapse surgery may take place through your:
You should follow your healthcare provider’s instructions to prepare for rectal prolapse surgery. You may need to:
What happens during rectal prolapse surgery depends on the approach your surgeon takes. Your surgeon thinks about your overall health and how big the prolapse is as they decide which approach is best for you.
There are different ways to perform rectal prolapse surgery through your abdomen. No matter which approach your surgeon chooses, they’ll give you general anesthesia.
Perineal surgery (also called perineal proctosigmoidectomy) takes place through a small incision in your perineal area. You may receive general anesthesia or an epidural.
There are different methods for treating rectal prolapse, the most common being surgery. Types of rectal prolapse surgery include:
You may stay in the hospital for two or three days after perineal surgery or up to a week after abdominal surgery. Your discharge time depends on several factors, like when you’re able to have solid foods, pass gas and poop (have a bowel movement). These signs indicate that your digestive system is working properly.
After surgery, you may experience:
Your healthcare provider will select the best surgical method for your unique diagnosis. Certain factors can make perineal surgery a better option than abdominal surgery.
These factors include:
Surgery is the only way to treat rectal prolapse in adults. Failing to get rectal prolapse surgery can lead to:
Abdominal surgery for rectal prolapse requires one larger incision or multiple smaller incisions. These make the procedure slightly riskier than perineal surgery, but it also has a lower risk of the prolapse happening again. All surgeries carry a risk of complications like bleeding, blood clots and scarring.
Complications of rectal prolapse surgery (rectopexy) include:
After you leave the hospital, it can take a few to several weeks to return to normal. Bowel function after the surgery may be the same, worse or better. It sometimes takes several months to determine what bowel function will be like long term.
After treatment, you may need to:
There’s some evidence that abdominal rectal prolapse surgery provides better long-term results than perineal surgeries.
Less than 5% of people who get abdominal rectopexy have another rectal prolapse. But as many as 1 in 4 people have another prolapse after perineal rectopexy.
You should call your healthcare provider if you experience:
You should expect to feel some pain or discomfort in your rectal area after surgery. If you had an abdominal procedure, your abdomen may also be tender. Follow your healthcare provider’s recommendations for pain relief.
A note from Cleveland Clinic
You might feel embarrassed to talk about things like anal pain or itching. But it’s important to let your healthcare provider know if you’re experiencing these symptoms. Rectal prolapse won’t go away without surgery (rectopexy). In fact, the problem will only get worse the longer you wait. Getting rectal prolapse surgery can stop symptoms and improve your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 05/05/2023.
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