Rectal prolapse is when the rectum (the lower part of the colon where stool forms) drops outside of the body, protruding through the anus. Common in older adults with a history of constipation, rectal prolapse is more prevalent in women over the age of 50. Symptoms of rectal prolapse include bleeding from the rectum and an uncontrolled loss of stool (fecal incontinence).
Rectal prolapse is usually caused by a weakening of the muscles that support the rectum. Rectal prolapse may be partial, involving only the mucosa, or it may be complete, involving the entire wall of the rectum. In early stages, a prolapse may happen only after straining during a bowel movement. The protruding rectum may then slip back through the anal canal on its own. Over time, the prolapse may become more severe and could require surgery.
If your rectal prolapse is severe enough and interferes with your quality of life, you may need surgery. Colon and rectal surgeons at BWH offer a range of minimally invasive surgical treatments, including:
Rectopexy (laparoscopic or open) A small incision is made through the lower belly, and the rectum is attached to the lower part of the backbone to support it and keep it in place.
Rectopexy with sigmoid resection (laparoscopic or open) Your surgeon may recommend sigmoid resection, in addition to rectopexy.
Perineal proctectomy The part of the rectum that has prolapsed is removed and the two ends are joined.
Your surgeon may recommend non-surgical approaches to prevent rectal prolapse and relieve symptoms:
You will receive a thorough diagnostic examination to evaluate if you have rectal prolapse and if surgery is needed. Careful monitoring and the involvement of an experienced colon and rectal surgeon are important to the successful outcome for patients with colorectal conditions.
The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in rectal prolapse surgery. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues who have extensive experience in diagnosing and treating rectal prolapse. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.