In its early stages, rectal prolapse may be treated with stool softeners, suppositories and other medications. But most people eventually need surgery to repair rectal prolapse.
At Mayo Clinic, colorectal surgeons work with other specialists as needed to treat any other pelvic organ prolapse you have. In most cases only one surgery is needed.
The type of surgery you have depends on the extent of the rectal prolapse and any other health concerns. Surgeons at Mayo Clinic will select the surgery that is right for you. They may recommend one of these procedures.
- Perineal proctectomy. Options include the Altemeier procedure and the Delorme procedure. In both procedures, the surgeon removes the prolapsed rectum via an incision in the protruding rectum. Perineal proctectomy can sometimes be performed using spinal anesthesia, which reduces the risk of complications and speeds your recovery.
- Sigmoid resection and rectopexy. The surgeon makes an incision in the abdomen and removes the sigmoid colon, the part of the large intestine closest to the rectum and anus. The rectopexy procedure anchors the rectum to a bony structure attached to the lower spine and pelvis (sacrum). In most cases it is possible to perform this operation using minimally invasive surgery, which results in smaller incisions and a shorter hospital stay than does conventional surgery.
- Rectopexy. Sometimes surgeons will perform rectopexy alone, without removing any of the colon. In this case they may use robotic surgery.
In children, rectal prolapse can usually be managed with stool softeners or other medication. If surgery is needed, Mayo Clinic surgeons have special experience in minimally invasive techniques.
Children with rectal prolapse should be screened for cystic fibrosis, since rectal prolapse can be a sign of that disease.
Mayo Clinic offers intensive outpatient biofeedback therapy, one type of physical therapy for pelvic floor dysfunction. Specially trained physiotherapists teach simple exercises that can increase anal muscle strength. People learn how to strengthen pelvic floor muscles, sense when stool is ready to be evacuated and contract the muscles if evacuation is inconvenient. Biofeedback therapy can be used before or after surgery. It may not eliminate the need for surgery, but it can make surgery more successful by helping to prevent rectal prolapse recurrence.
Insurers vary in their coverage of biofeedback therapy. Check your coverage before scheduling treatment.
March 27, 2015
- Bordeianou L, et al. Rectal prolapse: An overview of clinical features, diagnosis, and patient-specific management strategies. Journal of Gastrointestinal Surgery. 2014;18:1059.
- Walters MD. Urogynecology and Reconstructive Pelvic Surgery. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed Jan 27, 2015.
- Varma MG, et al. Surgical approach to rectal procidentia (rectal prolapse). http://www.uptodate.com/home. Accessed Jan. 27, 2015.
- AskMayoExpert. How is physical therapy used to treat pelvic floor muscle dysfunction? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- AskMayoExpert. How is biofeedback used to treat pelvic floor muscle dysfunction? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Jan. 27, 2015.
- Chua HK (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 21, 2015.
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