If you and your doctor have tried treating your rectal prolapse with dietary changes and stool softeners and your condition is getting worse, your doctor might recommend surgery. The timing of surgery is important since waiting too long could lead to nerve damage or other complications that leave you with fecal incontinence.
Your doctor will probably do a variety of tests that include a colonoscopy, transit time test, MRI, or barium enema. They may also measure pressures in your colon and observe you as you squat and push. The information they gather lets them know if it's time for surgery and what type of surgery is needed. Here are some surgical procedures that treat rectal prolapse.
Surgery Through The Rectum
This rectal prolapse treatment is done through the rectum, so there is no need for an abdominal incision. This makes recovery less painful and quicker. To do this procedure, the surgeon causes your rectum to prolapse so it can be pulled out far enough to remove the prolapsed portion. The end of your colon is then pulled down and attached to your anus.
This surgery might be done with a spinal block or with IV sedation and a local anesthetic. This surgery is sometimes chosen if you're older or have medical conditions that increase the risk of complications with an abdominal procedure.
Surgery Through The Abdomen
This surgery involves making an incision on your lower abdomen so the doctor can access your rectum and colon. The surgeon loosens attachments to your rectum, pulls the rectum up higher, and then stitches it to the back of your pelvic area to hold it in place.
This rectal prolapse treatment might also include removing part of your colon if the surgeon thinks that would help chronic constipation and prevent future prolapse.
Abdominal surgery can be done with an open incision or laparoscopically. Laparoscopic surgery uses much smaller incisions, so you have an easier recovery. However, the procedure for lifting the rectum and removing part of the colon is the same as with open surgery.
Once you've had a surgical rectal prolapse treatment, you need to prevent constipation or another prolapse might develop. Your doctor may advise you on eating enough fiber so you don't have to strain with your bowel movements. They might even recommend stool softeners when they're needed.
You'll want to work closely with your doctor and follow their instructions for recovery and lifestyle changes so you have a lower risk of complications and avoid a return of your prolapse.