Rectal Prolapse Repair

Rectal prolapse repair is surgery to fix a rectal prolapse, in which the last part of the colon (called the rectum) sticks out through the anus.

Symptoms of rectal prolapsed repair are:

  • Mucus or blood discharge from the protruding tissue
  • Loss of urge to defecate (mostly with larger prolapses)
  • Pain during bowel movements
  • Awareness of something protruding upon wiping
  • Fecal incontinence (inability to control bowel movements)

Rectopexy and anterior resection are the two most common abdominal surgeries used to treat rectal prolapse. The patient is usually placed under general anesthesia for the duration of surgery. During rectopexy, an incision into the abdomen is made, the rectum isolated from surrounding tissues, and the sides of the rectum lifted and fixed to the sacrum (lower backbone) with stitches or with a non-absorbable mesh. Anterior resection removes the S-shaped sigmoid colon (the portion of the large intestine just before the rectum); the two cut ends are then reattached. This straightens the lower portion of the colon and makes it easier for stool to pass. Rectopexy and anterior resection may also be performed in combination and may lead to a lower rate of prolapse recurrence.

As an alternative to the traditional open surgery (laparotomy) and the anal surgery, laparoscopic surgery may be performed. Laparoscopy is a surgical procedure in which a laparoscope (a thin, lighted tube) and various instruments are inserted into the abdomen through small incisions. Rectopexy and anterior resection have been performed laparoscopically with good results. A patient’s recovery time following laparoscopic surgery is shorter and less painful than following traditional abdominal surgery.

Risks associated with rectal prolapse surgery include potential complications associated with anesthesia, infection, bleeding, injury to other pelvic structures, recurrent prolapse, and failure to correct the defect. Following a resection procedure, a leak may occur at the site where two cut ends of colon are reattached, requiring surgical repair.

You will be encouraged to return to normal activities, such as showering, driving, climbing stairs, light lifting, and work, as soon as you feel comfortable. Some patients return to work in a few days while others prefer to wait longer. Strenuous activities should be avoided during the first weeks of recovery. If you are taking narcotic medications for pain, you should not drive.

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