By Mayo Clinic Staff
Rectal prolapse occurs when part of the large intestine's lowest section (rectum) slips outside the muscular opening at the end of the digestive tract (anus). The prolapsed rectum can cause fecal incontinence. Surgery is usually needed to treat rectal prolapse.
Comprehensive care. People with rectal prolapse often have other types of pelvic organ prolapse. Mayo Clinic's integrated practice gives you rapid access to all the experts needed to solve your problems. If you need surgery, Mayo specialists work together so that in most cases you have only one procedure.
- Experience. Each year doctors at Mayo Clinic treat more than 350 people who have rectal prolapse.
- Advanced techniques. State-of-the-art technology helps your doctor see moving images of the entire pelvis and determine the most appropriate treatment for you.
- Intensive physical therapy. Mayo offers comprehensive biofeedback treatment as a type of physical therapy to increase pelvic floor muscle strength.
- Timely care. A detailed itinerary for appointments, tests and procedures lets you make the most of your time at the clinic. Mayo Clinic technicians run all tests and labs themselves, which means tests taken in the morning can be reviewed the same afternoon. Mayo's collaborative approach means two or three days often yields the same diagnosis and care insights that could take weeks in less-coordinated institutions.
- Care at Mayo Clinic revolves around you. Mayo Clinic doctors get to know you and your concerns completely, and explain your options in plain language.
Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for digestive disorders by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for digestive disorders.
At Mayo Clinic, colorectal surgeons examine the entire pelvis to determine the extent of your rectal prolapse and whether you need surgery.
One test — dynamic MRI — is particularly helpful in diagnosing and planning treatment for rectal prolapse. This noninvasive test scans the entire pelvis during a bowel movement and produces a video of the pelvic muscles and pelvic organs at work. Dynamic MRI also reveals prolapse in other pelvic organs, such as the bladder or vagina.
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.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
Specialists in colon and rectal surgery at Mayo Clinic's campus in Arizona coordinate the diagnosis and treatment of people who have rectal prolapse.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in colon and rectal surgery at Mayo Clinic's campus in Florida coordinate the diagnosis and treatment of people who have rectal prolapse.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in colon and rectal surgery at Mayo Clinic's campus in Minnesota coordinate the diagnosis and treatment of children and adults who have rectal prolapse. Mayo offers an intensive two-week program of biofeedback therapy to treat rectal prolapse.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Mayo Clinic surgeons have made many advances in minimally invasive colorectal surgery to treat rectal prolapse. These procedures usually result in smaller incisions, less bleeding, quicker recovery and shorter hospital stays than does traditional surgery.
See a list of publications by Mayo Clinic doctors on rectal prolapse on PubMed, a service of the National Library of Medicine.
Oct. 12, 2016
- 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.