Rectal prolapse repair at Hereford Hospital

What is rectal prolapse?

A key symptom of rectal prolapse is tissue coming out of your anal passage after a bowel movement. The tissue may bleed slightly or be uncomfortable. You may also experience leaking from your bowels and constipation.

In the first stages the prolapse may retract back into your anus by itself. Later, the prolapse may remain exposed and need to be manually pushed back into place.

Prolapse can happen to young children but it is most often seen in older patients who may have a history of constipation.

Is rectal prolapse repair right for me?

In some cases, treatment of the underlying problem causing the prolapse (i.e. constipation) may resolve the prolapse. Your consultant may recommend changes in your diet, along with laxatives, stool softeners or bulking agents to ease constipation.

If conservative methods to treat your rectal prolapse aren't successful, your consultant may recommend rectal prolapse repair.

What happens during rectal prolapse repair?

Rectal prolapse repair is usually done under general anaesthetic. There are several techniques for this procedure and your surgeon will chose the best method for your situation:

• Open surgery through your abdomen (called a rectopexy). Your surgeon will pull your rectum back into your body and attach it to the bony area above your tailbone just below your spine (your sacrum). Sometimes surgical mesh is used to further support your rectum. A portion of your colon may also be removed. Your wound will be closed with stitches or staples.
• Laparoscopic (keyhole) rectopexy using several small incisions in your abdomen to perform the same procedure as in open surgery. Your wounds will be closed with stitches or staples.
• The perianal approach accesses the prolapse through the area around your anus. Several procedures may be used, including removing a portion of your rectum and attaching it to your colon, or removing the rectal lining and shortening your rectum. Perianal procedures result in internal wounds that won't be visible. You may have bruising in the area around your anus.

Recovery from rectal prolapse repair

Most people return to normal daily activities after 4–6 weeks. 

Short-term recovery

After your operation you'll be taken to a recovery area where our staff will monitor you and give you medication for pain relief.

You may have a catheter in your bladder to help you pass urine. This is usually removed the day after your surgery.

Our team of specialist physiotherapists will provide expert treatment, rehabilitation and advice during your hospital stay, and if appropriate follow-up as an outpatient to support your full recovery.

Your length of stay in hospital will depend on which surgical method your surgeon used. You won't be able to drive so please arrange for someone to drive you home on your day of discharge.

Managing your recovery at home

At home, follow dietary advice and restrictions and continue to take any medication prescribed. To prevent a recurrence of the prolapse, it's important to avoid straining while moving your bowels.

Avoid any strenuous activity or heavy lifting for 6 weeks. Discuss any return to work with your consultant.

Complications of rectal prolapse repair

Most people make a good recovery from rectal prolapse repair. As with any operation, there's a small chance of complications, such as:

• pain
• bleeding
• bruising
• infection
• blood clots (deep vein thrombosis – DVT).

Specific complications of rectal prolapse repair may include:

• bowel obstruction
• bowel incontinence
• damage to organs or nerves in the area
• failure of any joining made during the procedure
• recurrence of prolapse
• changes to bowel habits (diarrhoea or increased constipation).

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.