Will surgery cure my incontinence?

Correcting the prolapse often improves faecal incontinence, particularly if the incontinence was caused by the prolapse stretching the sphincter. If your sphincter muscles are weak for other reasons, you may still have some degree of incontinence after surgery. Pre-operative physiology tests help us predict this.

How long is the recovery after laparoscopic rectopexy?

Most patients stay in hospital for one to three nights. You can usually return to light activities within one to two weeks and to work within two to four weeks. Full recovery takes around six weeks.

What is the risk of the prolapse coming back?

Recurrence rates depend on the type of surgery. Laparoscopic abdominal procedures have the lowest rates at typically around 5%. Perineal procedures have higher rates around 10-30%. Following advice about diet and avoiding straining helps reduce the risk.

I am elderly. Is surgery still an option for me?

Yes. Perineal procedures like the Delorme or Altemeier operation can be performed under regional anaesthesia and are well-tolerated by older and frail patients. We carefully assess each patient's fitness and recommend the safest and most effective option.

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Rectal Prolapse Surgery

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Rectal prolapse is a condition in which the rectum loses its normal attachments inside the body and slides out through the anus, turning inside out. It can be distressing and debilitating, causing symptoms such as a visible lump protruding from the anus, mucus discharge, bleeding, and difficulty controlling bowel movements.

While it can occur at any age, it is most common in older women. A rectal prolapse will not resolve on its own and requires surgical treatment to correct. At Kinvara Private Hospital, we offer a range of surgical options from minimally invasive laparoscopic surgery to perineal procedures.

Medically Reviewed By

Mr Vasu Karri, Medical Director • Updated 2026-01-25

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The surgical treatment for rectal prolapse aims to return the rectum to its correct position and secure it in place. The choice of procedure depends on several factors including the patient's age, overall fitness for surgery, and the severity of the prolapse.

Abdominal approaches such as laparoscopic ventral mesh rectopexy are generally preferred for fitter patients as they have lower recurrence rates. Perineal approaches such as the Delorme or Altemeier procedures are performed through the anus without abdominal incisions and are often more suitable for older or frail patients.

Diagnosis and Assessment

Diagnosis of a full-thickness rectal prolapse is usually made on clinical examination. You may be asked to sit on a commode and strain as if having a bowel movement so the surgeon can see the prolapse. Your surgeon will also assess the function of your anal sphincter muscles.

To get a complete picture of your condition, further investigations may be recommended including proctoscopy, colonoscopy, defaecating proctogram or MRI, and anorectal physiology studies to measure sphincter muscle strength.

Understanding Rectal Prolapse

Rectal prolapse occurs when the supporting structures that hold the rectum in place within the pelvis become weakened, allowing the rectal wall to telescope through the anus. It is classified by severity. Internal prolapse is where the rectum folds in on itself but does not protrude outside the anus. Partial prolapse involves only the inner lining of the rectum protruding. Full-thickness external prolapse is where all layers of the rectal wall protrude through the anus appearing as concentric rings of tissue.

Rectal prolapse is often associated with long-standing constipation and straining and frequently co-exists with weakness of the pelvic floor muscles. Many patients also experience faecal incontinence.

Benefits of Surgery at Kinvara

Full range of surgical options including minimally invasive laparoscopic surgery
Expert assessment including functional investigations
Tailored surgical approach based on patient fitness and prolapse severity
Experienced surgeons with expertise in pelvic floor disorders
Comprehensive post-operative support and pelvic floor physiotherapy referral

What Causes Rectal Prolapse?

The exact cause of rectal prolapse is not always clear, but it is associated with weakness and laxity of the muscles and ligaments that support the rectum and pelvic floor. Contributing factors include chronic straining from long-term constipation, aging, childbirth, previous pelvic surgery, neurological conditions, and connective tissue disorders. Rectal prolapse is significantly more common in women than in men and the incidence increases with age.

Surgical Treatment Options

Conservative Management

There is no effective non-surgical treatment for a full-thickness rectal prolapse. For patients who are not fit for any surgery, the prolapse can be managed by manually reducing it when it protrudes and using a supportive pessary device. Attention to diet and bowel habit to avoid straining is also important.

Surgical Options

Surgical repair can be performed via an abdominal or perineal approach. Laparoscopic ventral mesh rectopexy is often the preferred procedure for fit patients where a mesh is placed on the front of the rectum through keyhole surgery with recurrence rates around 5%. Laparoscopic suture rectopexy uses sutures instead of mesh. Delorme's procedure involves stripping the prolapsed mucosa and plicating the underlying muscle, suitable for smaller prolapses or frail patients. Altemeier's procedure removes the prolapsed rectum through the anus, suitable for larger prolapses in patients who are not candidates for abdominal surgery.

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