COLORECTAL CONDITION · CONDITION GUIDE

Rectal Prolapse

Q: What is the difference between rectal prolapse and haemorrhoids?

Haemorrhoids are cushions of vascular tissue within the anal canal, while rectal prolapse involves the full thickness of the rectal wall protruding through the anus. Rectal prolapse produces a larger, circumferential red mass with concentric rings of mucosa, whereas haemorrhoids appear as discrete external swellings or internal cushions.

Q: Which operation is best for rectal prolapse?

Laparoscopic rectopexy offers the lowest recurrence rate and is preferred for fit patients. Perineal procedures (Delorme’s or Altemeier’s) are safer for elderly or frail patients and can be performed under spinal anaesthesia, avoiding the risks of abdominal surgery.

Q: Will bowel control improve after rectal prolapse surgery?

Many patients experience improvement in faecal incontinence after successful prolapse repair. Pelvic floor physiotherapy post-operatively significantly improves continence outcomes. A small proportion of patients may have persistent incontinence related to pre-existing sphincter damage.

A condition in which the rectum protrudes through the anus — causing discomfort, faecal incontinence, and rectal bleeding, treated surgically with perineal or abdominal repair.

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Rectal Prolapse minimally invasive treatment by Dr. Tagore

Women 50+ MOST AFFECTED

45–90 Min PROCEDURE DURATION

1–4 Days HOSPITAL STAY

ABOUT THIS CONDITION

What is Rectal Prolapse?

Rectal prolapse occurs when the full thickness of the rectal wall protrudes through the anal opening. It is most common in elderly women and may be associated with chronic straining, weak pelvic floor muscles, and neurological conditions. Symptoms include a reducible or irreducible rectal mass, faecal incontinence, mucous discharge, bleeding, and discomfort. Dr. Tagore Mohan Grandhi treats rectal prolapse at Lux Hospitals, Hyderabad, offering both perineal procedures (Delorme’s, Altemeier’s) for elderly or high-risk patients and laparoscopic rectopexy for fit patients seeking the lowest recurrence rates. The choice of operation is individualised based on age, fitness, prolapse severity, and bowel function.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Visible protrusion of red tissue through the anus during straining or standing Faecal incontinence or reduced sphincter control Mucous or bloody discharge from the prolapsed rectum Difficulty reducing the prolapse manually in advanced cases Sensation of incomplete evacuation after defaecation Perineal discomfort, soiling, and skin irritation

WHY IT HAPPENS

Causes & Risk Factors

Weak pelvic floor muscles due to ageing or childbirth
Chronic straining and constipation
Previous pelvic surgery or radiation affecting ligamentous support
Neurological conditions impairing pelvic floor innervation
Deep pouch of Douglas and lax lateral ligaments predisposing to intussusception
Long-term laxative use and sedentary lifestyle

CLINICAL DETAILS

KeyFacts

Perineal Options

Delorme’s procedure or Altemeier’s proctectomy

Abdominal Option

Laparoscopic rectopexy — lowest recurrence rate

Recurrence

5–10% with rectopexy; 15–25% with perineal procedures

Recovery

1–2 weeks for perineal; 2–4 weeks for laparoscopic

Patient Selection

Age, fitness, and sphincter function guide procedure choice

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

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Laparoscopic Rectopexy

Laparoscopic rectopexy achieves the lowest recurrence rates for rectal prolapse by fixing the rectum to the sacrum through a minimally invasive abdominal approach. Dr. Grandhi recommends this procedure for fit patients, offering durable repair, sphincter preservation, and a short recovery with small keyhole incisions.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Assessment & Functional Testing

Clinical examination confirms the diagnosis. Proctography and anorectal physiology testing assess sphincter function, pelvic floor strength, and degree of prolapse to guide procedure selection.
2

Patient Selection & Procedure Planning

Fit patients are offered laparoscopic rectopexy. Elderly or high-risk patients are offered perineal procedures (Delorme’s or Altemeier’s) under spinal or light general anaesthesia.
3

Surgical Repair

Rectopexy: the rectum is mobilised and fixed to the sacrum laparoscopically. Delorme’s: the prolapsed mucosa is stripped and the muscle plicated. Altemeier’s: the prolapsed bowel is excised and anastomosed perineally.
4

Recovery & Pelvic Floor Rehabilitation

Pelvic floor physiotherapy is commenced post-operatively. A high-fibre diet and bowel habit regulation are maintained. Follow-up at 6 weeks assesses symptom resolution and functional improvement.

AVAILABLE TREATMENTS

TreatmentOptions

Laparoscopic Rectopexy

Laparoscopic fixation of the rectum to the sacrum. Preferred procedure for fit patients with the lowest recurrence rate of all repair options.

Colorectal Surgery

Surgical repair restores the rectum to its normal position and helps prevent recurrent prolapse.

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COMMON QUESTIONS

Frequently Asked Questions

What is the difference between rectal prolapse and haemorrhoids?+

Which operation is best for rectal prolapse?+

Will bowel control improve after rectal prolapse surgery?+

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