What is Rectal Prolapse?

Rectal prolapse occurs when the full thickness of the rectal wall protrudes through the anus. It is more common in elderly women and causes discomfort, mucous and bloody discharge, and difficulty controlling bowel movements. Surgical repair is the definitive treatment.

Surgical Options

• Laparoscopic Rectopexy (Frykman-Goldberg / Orr-Loygue) — preferred in fit patients under 70. The rectum is mobilised and fixed to the sacrum through keyhole surgery. Recurrence rate <5%. Full recovery in 2–3 weeks.
• Delorme's Procedure — performed through the anus (perineal approach); mucosal stripping with muscle plication. Preferred for frail elderly patients unfit for general anaesthesia. Higher recurrence but minimal systemic risk.
• Perineal Rectosigmoidectomy (Altemeier) — for large, long-standing complete prolapses; rectum and sigmoid resected through the perineum.

Obstructed Defecation Syndrome (ODS)

ODS is a chronic inability to evacuate the rectum despite straining — caused by rectocoele, intussusception (internal prolapse), or sigmoidocoele. Treatment options include:

• STARR (Stapled Transanal Rectal Resection) — removes the excess rectal tissue causing the obstruction using circular staplers inserted through the anus. Day-care procedure, rapid recovery.
• Laparoscopic Ventral Rectopexy — repairs rectocoele and intussusception by fixing the anterior rectal wall to the sacral promontory with a mesh.
• Biofeedback and pelvic floor physiotherapy for functional ODS without structural abnormality.