Rectal Prolapse

Treatment

Treatment depends on the type of rectal prolapse:

• Full thickness (the full thickness of the rectal wall protrudes through the anus) is the most common type and most likely to need surgery.
• Mucosal prolapse — only the rectal mucosa, not the entire wall, protrudes from the anus.
• Internal prolapse — prolapsed tissue does not pass beyond the anal canal out of the anus.

In its early stages, rectal prolapse can be treated with stool softeners, suppositories and other medical treatments.

Surgery

Surgery is usually necessary to repair rectal prolapse; which kind depends upon the condition of the patient and the extent of the prolapse. Surgery is performed by a colon and rectal surgeon, who has completed training in general surgery as well as in the treatment of colon and rectal problems. These surgeons are board certified by both the American Board of Surgery and by the American Board of Colon and Rectal Surgery.

Mayo Clinic colon and rectal surgeons most often use one of the two following approaches:

Sigmoid Resection and Rectopexy

The surgeon makes an incision in the abdomen and removes the sigmoid colon, which is often longer in a person who has prolapse. The rectopexy procedure anchors the rectum to the sacrum (a bony structure attached to the lower spine and the pelvis). In most cases it is possible to perform this operation laparoscopically, which results in smaller incisions and a shorter hospital stay.

Mayo Clinic colon and rectal surgeons perform more than 1,000 colon resections each year.

Perineal Proctectomy (Altemeier Procedure)

The surgeon removes the prolapsed rectum via an incision in the protruding rectum, leaving no visible stitches. Mayo Clinic colon and rectal surgeons have extensive experience with this procedure.