What is rectal prolapse?
This is when the rectum comes out of the anal canal. It can come out during bowel motions or not. Sometimes the prolapse will go back in by itself and sometimes it requires pushing back in.
What are the symptoms?
There is a lump that comes out of the anus. It is usually not painful. If it is painful or cannot be pushed back inside then urgent surgery is required.
What is the treatment?
Surgery is often required. There are many different operations that depend on the size of the prolapse and fitness of the patient.
The prolapse can be removed (Altemeier operation) or pushed back and tightened (Delormes operation). These are fairly minor operations and reserved for elderly and unfit patients.
This involves pulling the rectum back into the abdomen and attached to the sacral bone with sutures or plastic mesh. Sometimes a part of the bowel is removed. These operations can be performed as a laparoscopic (key hole) or open operation.
What are the complications?
The complications related to the approach taken and will be discussed as appropriate by Dr Pathma-Nathan
Can the prolapse come back?
Prolapse is due to weakening of the supporting structures of the rectum. As a result all operations do have a recurrence rate. There is more recurrence with the more minor (perianal) operations.