Rectal prolapse

Treatment

In its early stages, rectal prolapse may be treated with stool softeners, suppositories and other medications. But most people need surgery to repair rectal prolapse.

At Mayo, 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. Mayo surgeons use these procedures:

• Perineal proctectomy (Altemeier or modified Delorme procedure). The surgeon removes the prolapsed rectum via an incision in the protruding rectum. Perineal proctectomy can be performed using a regional anesthetic, 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.

Children

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.

Biofeedback

Mayo offers intensive outpatient biofeedback therapy. 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 doesn't 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.