Rectal Prolapse

A rectal prolapse occurs when the rectum comes down from its normal place. Support structures and muscles of the pelvis and anus are weak. Straining during bowel movements, childbirth, age, family history, and spinal cord disease can cause this problem.

Symptoms

• Change in bowel habits

• Rectal bleeding

• Mucous drainage

• Anorectal pain or fecal leakage

• Feeling tissue come out of the anus while straining
  

Surgery
The surgeon looks at many issues such as age, health, degree of the prolapse, or test results to decide if surgery can help you. The hospital stay after surgery is 1-5 days but will depend on the type of surgery.

Abdominal Surgeries

The rectal prolapse may be repaired several ways. One way is through the abdomen.

Open Rectopexy
A longer incision (4 inches or longer) is made in the middle of the lower abdomen and the surgeon puts the rectum back in place. Using sutures or a mesh sling the rectum is anchored to the back wall of the pelvis. If there are extra loops of colon above the rectum, they may be removed. The recovery time is 4-6 weeks.

Laparoscopic Rectal Prolapse Repair
This surgery uses several small incisions and special instruments and a tiny camera through one of the small incisions to repair the prolapse. Recovery time is about 4 weeks.

Robotic Repair
This uses a robot to perform the abdominal surgery. The surgeon runs the robot from a console in which the instruments are controlled. Small incisions are made. Another surgeon will assist and stand close to you. Recovery time is about 4 weeks.

Transanal Surgeries

These are surgeries that are performed through the anal opening.

Altemeier Procedure
The rectum is pulled through the anus and a portion of the rectum and low colon is removed. The intestines are reattached to the intestine. Recovery time is 3-4 weeks.

DeLorme Procedure
This is used for smaller rectal prolapse. The lining of the rectum is removed, and the muscular layer is folded to shorten the rectum. The lining that was removed is then stitched back to cover the repair. Recovery time is 3-4 weeks.

Home Care

Diet
You will need to follow a low fiber diet after leaving the hospital. Keep your stool soft so you do not strain during bowel movements. You may need to take stool softeners or laxatives. Be sure to drink at least 8-10 (8 ounce) glasses of water a day. Your doctor will tell you when you can go back to your normal diet.

Pain
The amount of pain depends on the extent of your repair and the size and location of your incision(s). You may be given pain pills to take at home.

Activity

• Plan rest times during the day. You will feel tired.

• Check with your doctor before going back to work.

• Nothing more strenuous than walking until okayed by your doctor.

• Do not strain during bowel movements.

• Do not lift more than 20 pounds for 4-6 weeks.

• No sex until okayed by your surgeon

• No driving for 3-4 weeks or if you are taking narcotic pain pills
  

Incision Care

• Wear loose clothes.

• Two days after surgery you may shower and gently wash incisions with mild soap and water.

• Do not soak in a hot tub, bathtub, or go swimming until your incisions heal. This may be 2 weeks or longer.

• Do not put lotion, ointment, or powder on your incisions. You may wear Band-Aids if you wish.

• Expect small areas of bruising at the incision site.

• Check your incision daily for signs of infection:

  • Increased redness, swelling or warmth

  • Drainage such as blood or pus

  • Fever over 100.4 F by mouth for two readings taken 4 hours apart
    

Follow Up
You will see your surgeon in 1-2 weeks.

When to Call

• Signs of infection

• Painful bloating or cramping

• Pain not controlled by pain pills

• Return of the rectal prolapse

• Unable to have a bowel movement

• Unable to control bowel movements
  

Who to Call
Digestive Health Center
(608) 242-2800

After hours, weekends or holidays this number will be answered by the paging operator. Ask for the doctor on call or ask for __________________. Leave your name and phone number with area code. The doctor will call you back.

That toll-free number is (855) 342-9900.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.