Rectal prolapse may be partial, involving only the inner lining of the bowel (mucosa). Or, it may be complete, involving the entire wall of the rectum.
For most adults, surgery is used to repair the rectum because there is no other effective treatment.
Children with rectal prolapse do not always need surgery, unless their prolapse does not improve over time. In infants, prolapse often disappears without treatment.
Most surgical procedures for rectal prolapse are done under general anesthesia. For older or sicker people, epidural or spinal anesthesia may be used.
There are 3 basic types of surgery to repair rectal prolapse. Your surgeon will decide which one is best for you.
For healthy adults, an abdominal procedure has the best chance of success. While you are under general anesthesia, the doctor makes a surgical cut in the abdomen and removes a portion of the colon. The rectum may be attached (sutured) to the surrounding tissue so it will not slide and fall out through the anus. Sometimes, a soft piece of mesh is wrapped around the rectum to help it stay in place. These procedures can also be done with laparoscopic surgery (also known as keyhole or telescopic surgery).
For older adults or those with other medical problems, an approach through the anus (perineal approach) might be less risky. It might also cause less pain and lead to a shorter recovery. But with this approach, the prolapse is more likely to come back (recur).
One of the surgical repairs through the anus involves removing the prolapsed rectum and colon and then suturing the rectum to the surrounding tissues. This procedure can be done under general, epidural, or spinal anesthesia.
Very frail or sick people may need a smaller procedure that reinforces the sphincter muscles. This technique encircles the muscles with a band of soft mesh or a silicone tube. This approach provides only short-term improvement and is rarely used.