What is rectal prolapse?
Rectal prolapse is a condition in which the last part of the colon—the rectum—moves out of place. The rectum may protrude from the anus, or it may shift out of place internally.
Rectal prolapse may only happen during bowel movements—“partial prolapse”— or prolapsed tissue may protrude from the anus all the time—“complete prolapse”.
This condition can cause discomfort and leakage of stool, called fecal incontinence.
What are the risk factors?
While the causes of rectal prolapse are not always known, there are several things that can increase your risks:
- Frequent straining during bowel movements
- Damage to tissue caused by injury or childbirth
- Weakness of pelvic floor muscles
- Neurologic issues
- Genetic predisposition (rare)
What are the symptoms?
The symptoms of rectal prolapse are often the same as the symptoms experienced with hemorrhoids: bleeding from the rectum, and tissue that protrudes from the rectum.
Several other symptoms may also be present:
- Fecal incontinence (inability to control bowel movements)
- Leakage of mucus from anus
- Leakage of blood from anus
- Having very small stools
- Feeling of full bowels
- Inability to empty bowels completely
- Anal itching and irritation
- Bright red tissue protruding from anus
How is rectal prolapse diagnosed?
Rectal prolapse can often be diagnosed with a physical examination by a colorectal surgeon. In some cases, additional imaging techniques will be needed for a definite diagnosis.
Sigmoidoscopy. This test allows a doctor to see the interior of the rectum. It can usually be performed during an office visit.
Colonoscopy. A flexible scope is used to examine the entire length of the colon.
Barium enema. The rectum is filled with barium, a contrast dye. X-rays are then used to take pictures which show the shape and structure of the rectum.
Videodefecogram. X-ray images are taken during a bowel movement to show how the rectum is functioning.
How is rectal prolapse treated at URMC?
The University of Rochester Medical Center provides the most advanced surgeries to correct rectal prolapse. Surgery may be performed through the anus or through the abdomen.
Perineal rectosigmoidectomy is a method of repairing rectal prolapse that is performed through the patient’s anus. While under anesthesia, a portion of the patient’s rectum is removed. The remaining part of the rectum is then stitched to the end of the colon, eliminating the prolapsed portion.
Rectal prolapse surgery can also be performed through the abdomen, in a procedure called abdominal rectopexy. At URMC, our surgeons perform this surgery in a minimally invasive fashion. Several small incisions are made in the abdomen, and tiny surgical tools are inserted. The prolapsed portion of the rectum is pulled back inside the body. It is then stitched in place, helping keep prolapse from occurring again in the future.
With either of these procedures, patients typically remain in the hospital for a few days while they recover their bowel function.