Materiały źródłowe

• #1 Rectal prolapse – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectal-prolapse/diagnosis-treatment/drc-20450472

  Treatment for rectal prolapse often involves surgery. Treatment for constipation with stool softeners, suppositories and other medicines are often needed. There are different surgical methods for treating rectal prolapse. Your health care provider will pick the best treatment for you after going over your age, health problems and how your bowels work.

• #2 Rectal Prolapse: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14615-rectal-prolapse

  Not in adults. If rectal prolapse occurs in your child, it might go away after you treat the cause. For example, if your child has hard stools, diarrhea or a parasite infection, treating these conditions will relieve the stress on their pelvic floor muscles. The muscles will repair themselves as your child continues to grow. If you’re an adult, however, rectal prolapse won’t improve without surgery. […] There are several surgical approaches to fixing rectal prolapse. Which procedure you have will depend on the specifics of your condition. For generally healthy adults, the first choice is usually a rectopexy, which is a procedure to repair your rectum through your abdomen. However, some people might not be good candidates for abdominal surgery. In these cases, rectal surgery is another option.

• #3 Rectal Prolapse Treatment & Management: Approach Considerations, Nonoperative Management, Surgical Options

  https://emedicine.medscape.com/article/2026460-treatment

  In adult patients, treatment of rectal prolapse is essentially surgical; no specific medical treatment is available. (Children, however, can usually be treated nonsurgically and by managing the underlying condition.) Which repair constitutes the best treatment is the main controversy in surgery for rectal prolapse. […] Laparoscopic approaches to rectal prolapse repair have become increasingly popular. […] Although no medical treatment is available for rectal prolapse, internal prolapse should always be first treated medically with bulking agents, stool softeners, and suppositories or enemas. […] If the prolapse cannot be reduced and the viability of the bowel is in question, emergency resection is required. […] In cases of uncomplicated rectal prolapse, arrangements should be made for surgical follow-up care to provide further evaluation and definitive treatment.

• #4 Rectal prolapse | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectal-prolapse

  Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place. […] A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children. […] Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present (such as prolapsed bladder). Treatment options can include: Diet and lifestyle changes to treat chronic constipation for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children […] Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus. One operation involves tethering the rectum to the central bone of the pelvis (sacrum). Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.

• #5 Rectal Prolapse | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/rectal-prolapse

  The first line of treatment is aimed at preventing constipation and avoiding straining to have a bowel movement. A diet rich in fiber (2535 grams per day) along with 68 glasses of decaffeinated fluids every day will assist in keeping stools soft. […] Physical therapy can also help strengthen weakened muscles and improve pelvic muscle tone to make the pelvic floor stronger. If prolapse can be reduced easily and does not occur spontaneously, no special additional treatment is needed. However, if this is not the case and conservative measures have failed, surgical consultation is warranted. […] There are two basic types of operation for rectal prolapse: one requiring an abdominal approach and one that is done through the rectum. The abdominal approach usually involves resecting or removing the redundant part of the bowel that is coming out (resection) and tacking the rectum up on the inside so it cant come out again (rectopexy). […] Resection and rectopexy give the best long-term results and lowest recurrence rates.

• #6 Treatment for Rectal Prolapse | Bladder & Bowel Community

  https://www.bladderandbowel.org/bowel/bowel-treatments/rectal-prolapse-repair/

  Rectal prolapse occurs when part of your rectum, or the lining of your rectum, pushes through the anus. In the early stages of your condition, your doctor may advise treatments for rectal prolapse that are non-surgical. They may suggest you to eat plenty of fruit and vegetables and other foods that contain fibre to try to prevent constipation and reduce straining. […] If you have difficulty increasing your dietary fibre they may suggest you take bulking or osmotic laxatives, such as Fybogel, Movicol to help you empty your bowels without straining. Your doctor will also advise you to drink plenty of water, about 1.5-2 litres a day. […] Occasionally, your doctor may recommend your child has an injection of a substance called a sclerosant to help destroy the prolapsed tissue or surgery. However, this is only considered if other treatments have not been successful. It will also depend on how old your child is and how serious their condition is.

• #7

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abr9675

  Your doctor may diagnose a rectal prolapse by asking questions about your symptoms and doing a rectal exam. Home treatment often helps the problem, but you may need surgery. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Avoid constipation. Drink plenty of water, and eat fruits, vegetables, and other foods that contain fibre. Changes in diet often are enough to improve or reverse a partial prolapse. […] Try Kegel exercises to help strengthen the muscles of the pelvic area. […] Don’t strain during a bowel movement. Use a stool softener if you need to. […] If it happens again, and if your doctor says it’s okay, you can push the prolapse back into place.

• #8 Rectal Prolapse Exercises to Reduce the Risk of Rectal Prolapse Worsning

  https://www.pelvicexercises.com.au/rectal-prolapse-exercises/?srsltid=AfmBOooZhyRPeDM0CVAfKRugwg35x-hUz6ClMt7KVN3376_jB5gds9FS

  Rectal prolapse exercises and using the correct physiotherapy bowel emptying technique can help you manage and potentially reduce the risk of your rectal prolapse worsening. […] Rectal prolapse exercises may be beneficial. […] Rectal prolapse exercises are also known as pelvic floor exercises or Kegels. […] Training for everyday activities involves using your pelvic floor muscles when you need them to work. […] Bowel management to avoid rectal prolapse worsening involves managing 2 key aspects to reduce the need to strain: Correcting your stool consistency and Using the correct position and technique for bowel emptying. […] Straining is a key reason for rectal prolapse worsening. […] The correct bowel emptying technique with a rectal prolapse: Position your body in preparation for emptying by leaning forward keeping the inward curve in your lower back and your spine lengthened, both feet flat on the ground, hips wide apart and supporting your upper body by resting your hands on your thighs. […] Do your rectal prolapse exercises daily and gradually progress your exercises when you can. […] Practice good bowel habits using the correct technique for bowel emptying and never strain with bowel movements.

• #9

  https://www.iowaclinic.com/specialties/digestive-health/colorectal-surgery/prolapse-incontinence/rectal-prolapse-and-incontinence/

  Biofeedback Therapy: Biofeedback therapy involves using electronic sensors to monitor muscle activity in the pelvic floor and teach patients how to improve muscle coordination and control, potentially reducing symptoms of rectal prolapse. […] Surgery may be recommended for more severe or symptomatic cases of rectal prolapse that do not respond to conservative treatments. There are several surgical approaches to rectal prolapse, including: […] Rectopexy: This procedure involves surgically attaching the rectum to the surrounding tissues or the sacrum (the bone at the base of the spine) to provide support and prevent prolapse. […] Resection with or without Rectopexy: In cases where the rectum is extensively prolapsed or damaged, surgery may involve removing a portion of the rectum (resection) and reattaching the remaining rectum to the sacrum (rectopexy).

• #10 Display Patient Information Leaflets

  https://www.plymouthhospitals.nhs.uk/display-pil/pil-managing-a-rectal-prolapse-6624/

  A rectal prolapse occurs when there is insufficient support of the rectum, and this results in the rectum dropping outside of the back passage (anus). […] There are various strategies to help manage a rectal prolapse conservatively. A partial prolapse (in which it’s only the lining of the bowel that pops out) can usually be treated without surgery, although sometimes the extra tissue may need to be banded / suture repaired. However, a rectal prolapse may need to be surgically repaired, and there are two approaches either abdominally or via the back passage. The suitability of surgery and type will depend on various factors and will be discussed with your Consultant Surgeon, if necessary. […] Current treatments include conservative treatment of internal rectal prolapse which may include pelvic floor exercises and advice to improve defaecatory habits, reduce constipation and improve incontinence. These are often termed biofeedback or pelvic floor retraining. Surgical treatment of internal rectal prolapse is classified into perineal (Delorme’s operation) and abdominal procedures. Open abdominal surgery and laparoscopic procedures, with or without robotic assistance, use mesh or direct suturing and may involve resection of the sigmoid colon.

• #11 Rectal Prolapse: Symptoms and Treatment | Doctor

  https://patient.info/doctor/rectal-prolapse

  Rectal prolapse can usually be reduced with gentle digital pressure. Sedation and local perianal anaesthesia may help the reduction. […] Prompt surgical referral is recommended for an irreducible prolapse and for strangulation or gangrene of the prolapsed tissue. […] Partial prolapse often responds to conservative measures but occasionally requires excision of prolapsed mucosa. […] The aim of treatment is to eliminate the prolapse, correct associated bowel function and prevent new onset of bowel dysfunction. […] Multiple surgical repairs are available, but treatment must be based on individual symptoms and the presence or absence of constipation or other pelvic floor disorders. […] Mesh repairs have shown promising results, but carry the added risks of mesh erosion, infection, and mesh migration.

• #12 Rectal Prolapse Treatment | UVA Health

  https://uvahealth.com/services/gastro/rectal-prolapse

  The sooner your rectal prolapse is treated, the better the outcome. Gentle pressure on your rectum can sometimes push it back into place. Talk with your doctor about the best plan for you. […] In some cases, surgery may be needed: […] Laparoscopic rectopexy uses a tiny camera, called a laparoscope, to help secure your rectum in place with stitches. […] Perineal proctectomy removed part of your rectum.

• #13 Rectal prolapse and perineal repair – Overview | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/rectal-prolapse-and-perineal-repair

  A rectal prolapse can be treated by surgery called a perineal repair (Delormes operation or Altemeier procedure). […] During surgery, the lining of the bowel, or the section of bowel that has prolapsed, is removed and stitched back together. […] There are other treatment options for a rectal prolapse. The treatment decision is made depending on the type of prolapse you have, any previous surgery you have had and your medical health. […] A specialist nurse or physiotherapist can teach you a combination of correct techniques for going to the toilet, pelvic floor exercises, and methods of emptying your bowels (having a poo) to avoid discomfort. This can prevent further prolapse or incontinence. […] It might be possible to try rectal irrigation. This involves putting a tube or cone into your bottom and squirting up water. This allows the poo to be flushed out of your bowel. […] An abdominal approach involves repairing the prolapse by making a cut into the tummy.

• #14 Rectal Prolapse Surgery (Rectopexy): Recovery & Complications

  https://my.clevelandclinic.org/health/treatments/4550-rectal-prolapse-surgery-rectopexy

  Adults with rectal prolapse need surgery to put rectal tissue that slips into their anus back where it belongs. Rectal prolapse surgery (rectopexy) may take place through your abdomen or perineum (a perineal rectosigmoidectomy). Without surgery, rectal prolapse can worsen fecal incontinence and lead to more serious issues. […] Rectal prolapse isnt a medical emergency, but it gets worse over time if it isnt fixed with rectal prolapse surgery. Your surgeon can put the tissue back where it belongs so you dont develop pain, problems with pooping (incontinence or constipation) or other serious complications. […] Surgery is the only way to treat rectal prolapse in adults. Failing to get rectal prolapse surgery can lead to: Constipation. Fecal (bowel) incontinence. Gangrene from an incarcerated (stuck) rectum. Rectal ulcers and anemia.

• #15 Rectal Prolapse Treatment & Management: Approach Considerations, Nonoperative Management, Surgical Options

  https://emedicine.medscape.com/article/2026460-treatment

  Surgical treatments can be divided into two categories according to the approach used to repair the rectal prolapse: abdominal procedures and perineal procedures. […] On the whole, the abdominal procedures have a lower recurrence rate but a higher morbidity. […] The choice of procedure is also dictated by the presence or absence of constipation. […] Regardless of the type of procedure being planned, full mechanical and antibiotic bowel preparation should be carried out before surgery. […] Laparoscopic surgical rectopexy procedures have been developed that have outcomes as good as those of open abdominal procedures but are associated with shorter hospital stays and greater patient comfort. […] In a systematic review and meta-analysis comparing mesh rectopexy with resection rectopexy for the treatment of rectal prolapse, Koimtzis et al found that the two procedures did not differ significantly with regard to operating time, length of stay, overall complications, surgical-site infection (SSIs), cardiopulmonary complications, improvement in constipation or incontinence, or recurrence.

• #16

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse

  If left untreated, rectal prolapse does not turn into cancer. But, the amount of prolapsing tissue will likely increase over time. […] Definitive treatment of rectal prolapse requires surgery. […] There are several methods used to surgically repair rectal prolapse. Generally speaking, rectal prolapse can be repaired either through the abdomen, or from the bottom (by operating on the perineal side). Options include removing part of the rectum, or pulling the rectum back up and anchoring it. […] The optimal treatment depends on the size of the prolapse and the patients overall health. An abdominal approach offers the best chance for a long-term successful repair of rectal prolapse, provided the patient is medically fit for surgery. […] For rectal prolapse repair through the abdomen, the surgeon might make an incision in the lower abdomen, or use minimally invasive techniques such as laparoscopy or robotic-assisted surgery.

• #17 Rectal Prolapse: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14615-rectal-prolapse

  This procedure restores your rectum to its original position in your pelvis. Your surgeon will attach your rectum to the back wall of your pelvis (your sacrum) with permanent stitches. They may also reinforce it with mesh. These will hold your rectum in place long enough for scar tissue to develop, which will hold it in place after that. Rectopexy has a 97% long-term success rate in fixing rectal prolapse. […] If abdominal surgery isn’t an ideal option for you, your surgeon may approach your rectal prolapse through your anus. Rectal surgery doesn’t always require general anesthesia as abdominal surgery does. Some people can have it with epidural anesthesia. The rectal or perineal approach may also be a better choice if you have a very minor prolapse, or if your rectum is stuck on the outside (incarcerated).

• #18 Rectal Prolapse: Symptoms, Causes, Treatment, Surgery

  https://www.webmd.com/digestive-disorders/what-is-rectal-prolapse

  Rectopexy is successful in treating rectal prolapse in about 97% of cases. […] Also called rectal repair, this may be used if you are older, have minor prolapse, or if your rectum is stuck to the skin outside of the body. […] The risks involved with rectal prolapse surgery include: […] You will spend a short time in the hospital, maybe just overnight. […] To avoid constipation and rectal prolapse return, your doctor will have you drink lots of water, eat plenty of fiber, and use stool softeners. You should be able to return to normal activities 4-6 weeks after surgery.

• #19 Rectal Prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3140332/

  Rectopexy combined with anterior sigmoid resection is currently the most popular operation in the United States for rectal prolapse. Recurrence rates in the order of 0 to 9% are expected. […] The perineal approach is attractive because of similar recurrence rates to abdominal procedures and easier repeatability if recurrence occurs. The perineal approach is less invasive than open approaches and is associated with shorter hospital stays. […] The perineal rectosigmoidectomy is the procedure of choice for patients presenting with an incarcerated, gangrenous rectal prolapse. […] The perineal rectosigmoidectomy with levatorplasty has the largest recurrence-free interval, the lowest recurrence rate, and the most salutary effects on constipation and incontinence. […] Delorme first described this procedure in 1900. This procedure is well suited for patients with partial circumference or short-segment full-thickness prolapse.

• #20

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse

  The intent is to hold the rectum in the appropriate position until the body heals and scar tissue forms, securing the rectum in place. […] For patients with a long history of constipation, the surgeon may recommend removal of a portion of the colon during this operation in order to improve their bowel function. […] The choice to undergo a perineal approach to repair of rectal prolapse depends upon a number of factors, but these patients tend to be older, with more serious medical problems, or are undergoing emergency surgery for incarcerated prolapse. […] The most common perineal approach is the perineal rectosigmoidectomy or Altemeier procedure, named after the surgeon who popularized this operation. […] This surgery can be performed without general anesthesia and it is associated with less post-operative pain and a shorter hospital stay.

• #21 Current diagnostic tools and treatment modalities for rectal prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10294152/

  Stapled transanal rectal resection is another transperineal approach that may be a good alternative, especially for patients with obesity who experience obstructive defecation, associated rectocele, rectal intussusception, and satisfactory sphincter performance. […] Abdominal procedures are generally preferred for patients fit to withstand surgery without age concerns because of lower recurrence rates and better functional outcomes. […] Although the outcomes of open, laparoscopic, and robotic repairs are similar, minimally invasive approaches are more common because of faster recovery, lower morbidity, decreased postoperative pain, and lesser blood loss. […] The plane of rectal dissection is a controversial issue in rectal prolapse surgery. […] Although a relatively new technique, ventral mesh rectopexy is the most common procedure for rectal prolapse in Europe.

• #22 Current diagnostic tools and treatment modalities for rectal prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10294152/

  The laparoscopic and robotic approaches do not differ in terms of rates of conversion to open surgery. […] A meta-analysis of eight studies suggested that robotic surgery is associated with significantly fewer complications than laparoscopic surgery; furthermore, the recurrence rates do not differ significantly between the two. […] After surgery, patients should be advised against lifting, engaging in sexual intercourse, and consuming laxatives for at least 6 weeks postoperatively. […] In patients with early recurrence of full-thickness rectal prolapse, the European Society of Coloproctology guidelines recommend reoperation to reattach the mesh to the sacral promontory.

• #23 Rectal Prolapse Treatment in Portland, OR | Colorectal Health Northwest | Colon & Rectal Surgeon

  https://www.nwcch.com/rectal-prolapse

  Rectal prolapse is treatable with the right care. […] At Northwest Center for Colorectal Health, we take a comprehensive approach to treating rectal prolapse. Our doctors begin with a thorough evaluation to determine the severity of the condition and any underlying factors contributing to it. […] For mild cases or rectal prolapse, non-surgical treatments such as dietary changes, stool softeners, or pelvic floor therapy may be recommended to manage symptoms and prevent worsening. […] For more advanced cases, surgical intervention is often necessary to repair the prolapse and restore normal function. […] Our team specializes in minimally invasive surgery, frequently using the da Vinci surgical robot for robotic rectopexy. […] For patients who should avoid major abdominal surgery, we may recommend an alternative approach, such as the Altemeier or Delorme procedure, to remove the prolapsing portion of the rectum through the anus. […] These procedures are designed to provide long-term relief and improve your quality of life.

• #24 Current diagnostic tools and treatment modalities for rectal prolapse

  https://www.wjgnet.com/2307-8960/full/v11/i16/3680.htm

  Patients with rectal prolapse should be subjected to detailed history taking, thorough physical examinations, and assessments with appropriate scoring systems before deciding to proceed with surgical intervention. The aim of surgery is an anatomical correction to obtain optimal functional outcomes. […] To date, robotic and laparoscopic ventral mesh rectopexies are the most commonly performed surgeries and achieve better functional and anatomical outcomes than other surgical alternatives. […] Optimal treatment options for rectal prolapse remain controversial; even recent publications and systematic reviews have not recommended the most appropriate treatment option. […] Surgical treatment is indicated for internal prolapse of Oxford grades III-IV and symptomatic external rectal prolapse.

• #25 Rectal Prolapse Treatment & Management: Approach Considerations, Nonoperative Management, Surgical Options

  https://emedicine.medscape.com/article/2026460-treatment

  Perineal procedures have higher recurrence rates but lower morbidities and are often performed in elderly persons or in patients for whom general anesthesia is contraindicated. […] In a study of 32 patients with external rectal prolapse, Hetzer et al concluded that perineal stapled prolapse resection is a fast and effective treatment for this condition. […] The investigators reported no intraoperative complications, though two patients experienced minor postoperative complications.

• #26 Rectal prolapse | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectal-prolapse

  Surgery is the best option for severe rectal prolapse. Other possible forms of treatment may include: Lifestyle changes including high-fibre diet, drinking plenty of water and getting regular exercise […] While surgery through the abdomen gives better results, older people may be advised to undergo surgical correction of rectal prolapse via the anus, since this procedure is less stressful on the body. Surgery gives good results in most cases of rectal prolapse, but some people may find that symptoms such as constipation or the inability to completely empty the bowels continue.

• #27 Rectal Prolapse: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14615-rectal-prolapse

  In this procedure, your surgeon pulls the prolapsed rectum out through your anus and removes it. They may also remove the lower part of the colon (sigmoid colon) if it is involved in the prolapse (proctosigmoidectomy). Then they sew the two ends of your large intestine (your remaining colon and your anus) back together. The new end of your colon now becomes your new rectum. […] If you only have a mucosal prolapse, or a small external prolapse, your surgeon may choose a more minor procedure. The Delorme procedure only removes the prolapsed mucosal lining of your rectum. Your surgeon then folds back the muscle wall of the rectum onto itself and stitches it together inside your anal canal. The double muscle wall helps to reinforce the rectum. […] Rectal prolapse is usually the result of a long, gradual process of muscle deterioration. It’s not a medical emergency, but it can be dismaying when it occurs. Some deterioration is inevitable, but self-care can make a difference. By paying attention to your bowel health and exercising your pelvic floor muscles, you can help keep your pelvic organs in the best condition possible. If prolapse does occur, surgery can fix it.

• #28 Current diagnostic tools and treatment modalities for rectal prolapse

  https://www.wjgnet.com/2307-8960/full/v11/i16/3680.htm

  Surgical treatment options are generally divided into two categories, namely abdominal and perineal approaches. […] Generally, frail older patients with comorbidities are better candidates for perineal operations because these procedures can be performed under locoregional anesthesia with lower perioperative morbidity and shorter hospital stays. […] Among perineal interventions, the Delorme procedure (resection of the mucosa and plication of the rectal wall) is generally preferred for short-segment prolapse (≤ 5 cm long) and the Altemeier procedure (perineal proctosigmoidectomy) is reserved for long-segment prolapse; both techniques achieve similar results in terms of recurrence. […] Surgical treatment options are generally divided into two categories, namely abdominal and perineal approaches.

• #29 Rectal Prolapse Surgery: Symptoms, Causes, Diagnosis & Treatment

  https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/diseases-and-conditions/rectal-prolapse

  Rectal procedures are often used in older patients and in patients with more medical problem. Spinal anesthesia or an epidural may be used instead of general anesthesia in these patients. The two most common rectal approaches are the Altemeier and Delorme procedures. […] Altemeier procedure. In this procedure, also called a perineal proctosigmoidectomy, the portion of the rectum extending out of the anus is cut off (amputated) and the two ends are sewn back together. The remaining structures that help support the rectum are stitched back together in an attempt to provide better support. […] Delorme procedure. In this procedure, only the inner lining of the fallen rectum is removed. The outer layer is then folded and stitched and the cut edges of the inner lining are stitched together so that rectum is now inside of the anal canal.

• #30 Rectal Prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3140332/

  Another option for severely ill patients, with significant comorbidities or portal hypertension, is anal encirclement. This method does not correct the prolapse, rather it provides a physical barrier preventing further prolapse. […] The ultimate decision should be made by the patient and physician after reviewing the options, risks, and benefits of the various operative techniques, and which approach best suits the individual patient.

• #31 Rectal prolapse repair – UF Health

  https://ufhealth.org/conditions-and-treatments/rectal-prolapse-repair

  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. […] The surgery usually works well at repairing the prolapse. Constipation and incontinence can be problems for some people.

• #32 A to Z: Rectal Prolapse (for Parents) – Children’s Health Network

  https://kidshealth.org/ChildrensHealthNetwork/en/parents/az-rectal-prolapse.html

  Rectal prolapse most commonly affects young children and the elderly. Treatment usually requires a doctor to gently push the prolapsed rectum back into place, but in some cases, particularly with adults, surgery may be needed to correct the condition. […] A rectal prolapse usually doesn’t cause pain, and treating the cause usually cures the prolapse. About 90% of kids under 3 years old who get rectal prolapse can be treated without surgery, and in many of those cases a prolapse won’t occur again. Surgery, when necessary, usually is successful.

• #33 Surgery beats sclerotherapy for rectal prolapse in children ages 5 and older – Boston Children’s Answers

  https://answers.childrenshospital.org/rectal-prolapse-surgery/

  Overall, when used as an initial management approach, surgery had a significantly higher success rate for rectal prolapse than sclerotherapy. […] Rectal prolapse often resolves spontaneously and can be treated medically. However, children with severe or recurrent rectal prolapse require further treatment, typically in the form of sclerotherapy or surgical correction. […] After comparing medical management, sclerotherapy, and surgical correction (rectopexy or transanal resection) as initial treatment strategies, the team found that only 33 percent of patients resolved with sclerotherapy alone, compared to 79 percent who underwent surgery as initial management. Overall, when used as an initial management approach, surgery had a significantly higher success rate than sclerotherapy, even after controlling for severity of disease, psychiatric diagnosis, age, and other factors.

• #34 Rectal Prolapse | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/rectal-prolapse

  Most mild cases of rectal prolapse can be treated by your child’s physician, who will manually push the prolapse back in place. They will also make recommendations that address the cause of prolapse, such as giving your child a stool softener and increasing dietary fiber to improve regular bowel movements. […] If your child experiences frequent or severe rectal prolapse, you may need to see a specialist to treat the underlying condition. Depending on the type of prolapse, your child may require surgical intervention. The doctor will discuss the best treatment options with you. These may include: […] Sclerotherapy, in which a sclerosing agent is injected around the rectum to scar the surrounding tissue and keep the prolapse in place […] Thiersch cerclage, in which a wire or other thin material is used to narrow the anus […] Trans-anal resection, in which surgeons remove the prolapse through the anus […] Laparoscopic sigmoid resection, in which surgeons remove the sigmoid colon […] Rectopexy, in which the rectum is sutured to the sacrum.

• #35 Rectal Prolapse: Symptoms and Treatment | Doctor

  https://patient.info/doctor/rectal-prolapse

  Surgery may also be used in cases of complicated rectal prolapse – eg, recurrent rectal prolapse that requires manual reduction, painful prolapse, ulceration and rectal bleeding. […] One study reported that the use of laparoscopy in the management of complete rectal prolapse (using sutures, mesh, resection or levatorplasty) is safe, effective and associated with improved functional outcome.

• #36 Pediatric Rectal Prolapse Treatment & Management: Approach Considerations, Manual Reduction, Conservative Management

  https://emedicine.medscape.com/article/931455-treatment

  Patients who present with a prolapsed rectum should undergo prompt manual reduction. […] Conservative management is appropriate in selected patients. Treatment should be directed to the underlying cause, since once treated, conservative management is usually successful. […] The author recommends a six-month trial of conservative management in all patients under age four. Surgical treatment is reserved for patients with neuromuscular disorders or anatomic malformations. […] Some authors have reported excellent results with injection sclerotherapy. […] Surgical correction for IRP is possible through a transabdominal or transanal approach. […] Surgery is infrequently required for rectal prolapse. However, if the prolapse persists after an adequate trial of medical therapy, surgical intervention may be required.

• #37 Treatment for Rectal Prolapse | Bladder & Bowel Community

  https://www.bladderandbowel.org/bowel/bowel-treatments/rectal-prolapse-repair/

  Generally there are two approaches to surgery; the perineal and abdominal approach either by a repair through the anus without external incision (Delormes procedure) or through an incision in your abdomen (abdominal rectopexy). The rectopexy can be done laparoscopically with 4 or 5 very small incisions instead of one large incision across your lower abdomen. […] The choice of surgery depends on many factors including age, other health issues, presence of incontinence, surgeon preference and the size of the prolapse. Your surgeon will advise you on the best type of operation for you. […] Its important to remember that the rectal prolapse may come back after you have surgery by either method. The likelihood of a successful operation will depend on the type of surgery you have and your individual circumstances. It is important therefore to continue to reduce straining after having surgery. […] Following surgery normal activities can be resumed after 2 weeks but heavy lifting should be avoided for 6 weeks. It is important to avoid constipation and stool softeners and pain killers are usually given at discharge from hospital.

• #38 Rectal prolapse repair | Nuffield Health

  https://www.nuffieldhealth.com/treatments/rectal-prolapse-repair

  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. […] 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).

• #39 Rectal Prolapse: Symptoms, Surgery, Causes, and More

  https://www.healthline.com/health/rectal-prolapse

  There are two different types of perineal rectosigmoidectomy, which are surgical procedures that repair the rectal prolapse through the perineum, or the area between the anus and genitals. […] These surgeries are often recommended for people who have severe constipation and are not considered candidates for a laparoscopic procedure through the stomach. […] After rectal prolapse surgery, you may need to stay in the hospital to recover and regain bowel function. […] The amount of time you spend in the hospital can vary depending on the specific type of surgery you had. […] Generally, most people are able to fully recover and return to their normal daily activities within 6 weeks of surgery. […] Discuss your treatment options with your doctor. If they recommend one type of surgery, you should feel comfortable asking why it’s recommended.

• #40 Rectal Prolapse Surgery: Symptoms, Causes, Diagnosis & Treatment

  https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/diseases-and-conditions/rectal-prolapse

  The average length of hospital stay is three to five days but this varies depending on a patient’s other existing health conditions. Complete recovery can usually be expected in three months; however, patients should avoid straining and heavy lifting for at least six months. In fact, the best chance for preventing prolapse from recurring is to make a lifetime effort to avoid straining and any activities that increase abdominal pressure.

• #41 Rectal Prolapse Surgery | Colorectal Surgeons Newcastle

  https://www.colorectalsurgeonsnewcastle.com.au/rectal-prolapse-surgery-lambton-nsw.html

  Eating a healthy low fat, high fibre diet is strongly recommended to promote healing and a faster recovery as well as drinking 8 to 10 glasses of water daily to prevent constipation. Laxatives or stool softeners may also be recommended as needed. […] Most patients are discharged after 2 to 4 days of hospital stay depending on the type of surgery. […] A periodic follow-up appointment will be scheduled to monitor your progress. […] As with any surgical procedure, rectal prolapse surgery may also have certain risks and complications.

• #42 Rectal Prolapse Surgery | Colorectal Surgeons Newcastle

  https://www.colorectalsurgeonsnewcastle.com.au/rectal-prolapse-surgery-lambton-nsw.html

  Rectal prolapse surgery can be performed in two ways, either using the abdominal approach or through the rectal/perineal approach. […] The abdominal approach can be performed either through open surgery or laparoscopically. […] While you are under anaesthesia, your surgeon makes an incision in the abdomen and pulls the rectum back up in place, and uses a mesh sling or sutures to fix the rectum to the back wall of your pelvis (sacrum) so that it does not prolapse again. This procedure is known as rectopexy. […] This procedure is typically done for short prolapses and involves removing the lining of the rectum and folding the muscular layer to shorten the rectum. […] After your surgery, you will be transferred to the recovery area. […] Walking and moving around in bed is strongly encouraged as it lowers the risk of blood clots and pneumonia. It also helps to stimulate your bowels and assist with passing gas.

• #43

  https://www.nhs.uk/conditions/pelvic-organ-prolapse/treatment/

  For women with a prolapsed womb who have been through the menopause or do not wish to have any more children, a doctor may recommend surgery to remove the womb (hysterectomy). […] Occasionally, an operation that closes part or all of the vagina may be an option. […] Your doctor should have an in-depth discussion with you about the risks and benefits of the 4 different types of surgery, including mesh surgery, before you decide together whether one of them could be an option. […] Possible side effects of all 4 types of surgery, including mesh surgery, include: risks associated with anaesthesia, bleeding, which may require a blood transfusion, damage to the surrounding organs, such as your bladder or bowel, an infection you may be given antibiotics to take during and after surgery to reduce the risk, changes to your sex life, such as discomfort during intercourse but this should improve over time, vaginal discharge and bleeding, experiencing more prolapse symptoms, which may require further surgery, a blood clot (DVT) forming in 1 of your veins, such as in your leg you may be given medicine to help reduce this risk after surgery. […] You should be offered a check-up 6 months after surgery that includes a vaginal examination.

• #44

  https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-prolapse

  For a large majority of patients, surgery relieves or greatly improves symptoms. […] Factors that influence outcome after surgery include the condition of the anal sphincter muscles before surgery, whether the prolapse is internal (intussusception) or external, the length of time that the patient has experienced symptoms, and the overall health of the patient.

• #45 Rectal Prolapse – The Colorectal Center, PLC – Colorectal Surgery Nashville TN

  https://thecolorectalcenter.com/for-patients/other-conditions/rectal-prolapse/

  HOW IS RECTAL PROLAPSE TREATED? Although constipation and straining may be causes of rectal prolapse, simply correcting these problems may not improve the prolapse once it has developed. There are many different ways to surgically correct rectal prolapse. Abdominal or rectal surgery may be suggested. Your doctor can help you decide which method will most likely achieve the best result by taking into account many factors, such as age, physical condition, extent of prolapse and the results of various tests. […] Treatment of rectal prolapse depends on several factors: Patient’s age, Physical condition, Extent of prolapse, Test results. […] HOW SUCCESSFUL IS TREATMENT? Success depends on a number of factors, including the status of a patient’s anal sphincter muscle before surgery, whether the prolapse is internal or external, the overall condition of the patient and surgical method used. If the anal muscle has been weakened, either because of the rectal prolapse or for some other reason, it may in many cases significantly regain strength after the rectal prolapse has been corrected. Chronic constipation and straining after surgical correction must be avoided. A great majority of patients are completely relieved of symptoms, or are significantly helped, by the appropriate procedure.

• #46 Rectal Prolapse Surgery: Symptoms, Causes, Diagnosis & Treatment

  https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/diseases-and-conditions/rectal-prolapse

  As with any surgery, anesthesia complications, bleeding, and infection are always risks. Other risks and complications from surgeries to repair prolapse include: Lack of healing where the two ends of bowel reconnect (this can happen in a surgery in which a segment of the bowel is removed and the two ends of the remaining bowel are reconnected), Intraabdominal or rectal bleeding, Urinary retention (inability to pass urine), Medical complications of surgery: heart attack, pneumonia, deep venous thrombosis (blood clots), Return of rectal prolapse, Worsening or development fecal incontinence, Worsening or development of constipation. […] Success can vary depending on the condition of supporting tissues and the age and health of the patient. Abdominal procedures are associated with a lower chance of the prolapse reoccurring compared with perineal procedures. However, in most patients, surgery fixes the prolapse.

• #47 Rectal Prolapse Surgery (Rectopexy): Recovery & Complications

  https://my.clevelandclinic.org/health/treatments/4550-rectal-prolapse-surgery-rectopexy

  Theres some evidence that abdominal rectal prolapse surgery provides better long-term results than perineal surgeries. Less than 5% of people who get abdominal rectopexy have another rectal prolapse. But as many as 1 in 4 people have another prolapse after perineal rectopexy. […] Rectal prolapse wont go away without surgery (rectopexy). In fact, the problem will only get worse the longer you wait. Getting rectal prolapse surgery can stop symptoms and improve your quality of life.

• #48 How Do Doctors Treat Rectal Prolapse? — Dr. Dale Prokupek

  https://www.drdalemd.com/blog/2021/8/16/how-do-doctors-treat-rectal-prolapse

  These are the abdominal approaches to rectal prolapse surgery: […] Treating rectal prolapse with this method, the surgeon makes an incision in the lower abdomen. They then pull the rectum upwards and attach it to the back of the pelvic wall. Scarring will cause the rectum to attach permanently to the back of the pelvic wall. After using this method, 2-5% of cases relapse. […] Perineal approaches for rectal prolapse have fewer complications, better pain management, and a shorter stay at the hospital. […] In this procedure, there is no incision. Instead, the surgeon will cause the rectum to prolapse and then pull the excess colon out through the anus and remove it. Then they staple or sew it to the anus. […] The surgeon might occasionally decide to perform a mucosal sleeve resection when treating a rectal prolapse.

• #49 Rectal prolapse repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002932.htm

  Very frail or sick people may need a smaller procedure that reinforces the sphincter muscles. […] Risks of this surgery include: […] Return of prolapse after abdominal or perineal surgery. […] You should make a complete recovery in 4 to 6 weeks. […] The surgery usually works well at repairing the prolapse.

• #50 Rectal prolapse repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/rectal-prolapse-repair

  Very frail or sick people may need a smaller procedure that reinforces the sphincter muscles. […] Risks of this surgery include: […] Return of prolapse after abdominal or perineal surgery. […] The surgery usually works well at repairing the prolapse. Constipation and incontinence can be problems for some people.

• #51 Rectal Prolapse | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/rectal-prolapse

  An alternative approach is to remove the prolapsing bowel through the rectum. This is appropriate for patients who are in poor health and cannot tolerate an abdominal operation. It is usually well tolerated but has a higher long-term recurrence rate. […] Surgery is most successful for people who still have some control over their bowel movements. If the anal sphincter is already weak or damaged, surgery may correct the prolapse but not correct the fecal incontinence (lack of control of bowel movements) that usually accompanies prolapse. It is important to have strong muscles of the pelvic floor. It may be recommended to have a course of physical therapy before surgery. […] In some situations, if incontinence is severe, it may be necessary to do a diverting colostomy, so that the bowels no longer move through the rectum.

• #52 Current diagnostic tools and treatment modalities for rectal prolapse

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10294152/

  Rectal prolapse is a circumferential, full-thickness protrusion of the rectum through the anus. Multiple treatment modalities have been described, which have changed significantly over time. Particularly in the last decade, laparoscopic and robotic surgical approaches with different mobilization techniques, combined with medical therapies, have been widely implemented. […] Understanding the extent of complaints and ruling out differential diagnoses are essential for choosing a tailored surgical procedure. […] Optimal treatment options for rectal prolapse remain controversial; even recent publications and systematic reviews have not recommended the most appropriate treatment option. […] According to the practice guidelines proposed by the American Society of Colorectal Surgeons, the goal of a rectal prolapse surgery is to correct the prolapse without causing bowel dysfunction and improve the associated functional abnormalities.

• #53

  https://journals.lww.com/dcrjournal/fulltext/2017/11000/clinical_practice_guidelines_for_the_treatment_of.3.aspx

  In patients with acceptable risk, the procedure of choice for the treatment of rectal prolapse should typically incorporate transabdominal rectal fixation. […] Rectopexy is a key component in the abdominal approach to rectal prolapse. […] Sigmoid resection may be added to posterior suture rectopexy in patients with prolapse and preoperative constipation. […] Patients with a short segment of full-thickness rectal prolapse can be treated with mucosal sleeve resection. […] Rectal prolapse may be treated with a perineal rectosigmoidectomy.

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