What is Rectal Prolapse?

Rectal prolapse occurs when the wall of the rectum protrudes through the anus. It is more common in elderly women and is associated with chronic straining, multiparity and pelvic floor weakness. It causes discomfort, mucous discharge, bleeding and faecal incontinence. Left untreated, the condition worsens progressively.

Types

• Full-thickness external prolapse — the entire rectal wall protrudes outside the anus; visible as a red mass
• Internal intussusception — the rectum folds in on itself but does not protrude; causes ODS symptoms
• Mucosal prolapse — only the inner lining prolapses; appears similar to prolapsed haemorrhoids

Treatment at Charak Hospital

• Laparoscopic Rectopexy — gold standard for fit patients; the rectum is mobilised and fixed to the sacrum through keyhole surgery. Recurrence <5%. Full recovery 2–3 weeks.
• Laparoscopic Ventral Rectopexy — preferred approach; preserves posterior nerve supply and reduces post-operative constipation.
• Delorme's Procedure — perineal approach; mucosal stripping with muscle plication. For elderly or high-risk patients. Higher recurrence (10–15%) but minimal systemic risk.
• Perineal Rectosigmoidectomy (Altemeier) — for large, long-standing prolapses in high-risk elderly patients.