What is Rectal Prolapse?

A rectal prolapse is when the lower bowel, or the rectum, prolapses out through the anus. This is a very distressing and debilitating condition. It may cause bleeding, pain and leakage of stool.

Most commonly, it may be seen in older patients. However, it is not unknown for a rectal prolapse to appear in young adults too.

It is important to have a patient centred, multi-disciplinary approach to this problem.

The patient should be seen by a surgeon with a specialist interest in this field. The primary treatment for rectal prolapse is an operation under general anaesthetic.

The operation may be performed from the bottom end. In this the prolapse is trimmed away.

Or the operation may be performed through the abdomen, in which the prolapsing rectum is hitched up to the back of the pelvis, and so restore it to its usual position (rectopexy). This is usually performed with key-hole, or laparoscopic, surgery. This helps improve the recovery time from this operation and reduces the risk of complications afterwards.

The choice of operation depends on the individual patient. The recovery time from these operations is generally short. Patients are usually well enough to go home within a day or so after their operation. A mesh may be offered to help support the repair of a prolapse, when a rectopexy is undertaken. This requires a detailed discussion between the surgeon and patient, so that the specific risks of this are understood.

It is also important to address overall pelvic floor health in such patients. As such, the services of a pelvic floor nurse or physiotherapist should also be sought at this time.

Very often, those affected by a rectal prolapse will have other pelvic floor problems. By addressing these issues, the risk of recurrence of the prolapse is reduced and a better outcome is achieved for the patient.