Rectal Prolapse Procedures

Rectal prolapse is a condition in which the rectum loses its normal support and descends downward, sometimes protruding through the anus. When prolapse is suspected, physicians may recommend diagnostic procedures to confirm the diagnosis, assess pelvic floor function, and plan the most appropriate treatment.

Modern colorectal evaluation uses a combination of physical examination, functional testing, imaging, and surgical procedures tailored to the severity of prolapse and the patient’s symptoms.

Why Procedures Are Needed for Rectal Prolapse

Although some patients can describe a visible bulge or tissue protrusion, rectal prolapse is not always obvious during a routine office visit.

Procedures may be recommended when:

• The prolapse is intermittent or not visible during examination
• Symptoms suggest internal prolapse or pelvic floor dysfunction
• Patients have constipation, incomplete emptying, or fecal incontinence
• The diagnosis is uncertain
• Surgery is being considered

Early and accurate evaluation helps distinguish rectal prolapse from hemorrhoids and other anorectal conditions.

Common Procedures Used to Evaluate Rectal Prolapse

Several diagnostic procedures may be used depending on the symptoms and suspected type of prolapse.

Anorectal Examination

A careful anorectal examination is the first step in evaluating rectal prolapse.

During this evaluation:

• The doctor examines the anal and rectal area
• The patient may be asked to strain or bear down
• The physician assesses sphincter tone and pelvic floor function
• Visible prolapse may be documented during the visit

If the prolapse is not visible in the office, patients may be asked to describe the episode or share a photograph taken at home.

Defecography

Defecography is a specialized imaging study used when internal prolapse or pelvic floor dysfunction is suspected.

This procedure:

• Evaluates the rectum and pelvic floor during simulated bowel movements
• Helps identify internal rectal prolapse
• May detect associated problems such as rectocele or pelvic floor descent

Defecography may be performed using X-ray or MRI techniques depending on the clinical situation.

Anorectal Manometry

Anorectal manometry measures muscle function in the rectum and anus.

During this procedure:

• A small probe is placed into the rectum
• Pressure measurements are recorded
• Sphincter function and reflexes are evaluated

This test may be useful in patients with constipation, difficulty emptying, or fecal incontinence.

Colonoscopy

Colonoscopy may be recommended in selected patients with rectal prolapse, particularly when bleeding, changes in bowel habits, or colorectal cancer screening issues are present.

During colonoscopy:

• A thin flexible camera is inserted through the rectum
• The rectum and colon are examined
• Polyps or other structural lesions may be identified
• Other causes of bleeding can be ruled out

Colonoscopy is often performed before surgery when clinically indicated.

Learn more:
Colonoscopy

Surgical Procedures for Rectal Prolapse

Definitive treatment of full-thickness rectal prolapse is usually surgical. The best procedure depends on the patient’s anatomy, symptoms, age, and overall health.

Rectopexy

Rectopexy is a common abdominal procedure used to repair rectal prolapse.

During this procedure:

• The rectum is mobilized within the pelvis
• The rectum is pulled back into its normal position
• It is secured to the sacrum to reduce recurrence

Rectopexy may be performed through open, laparoscopic, or robotic approaches. In selected patients with significant constipation, a segment of colon may also be removed.

Perineal Rectosigmoidectomy

Perineal rectosigmoidectomy, also called the Altemeier procedure, is performed through the perineum rather than through the abdomen.

This procedure:

• Removes the prolapsed rectum and distal sigmoid colon
• Reconnects the remaining bowel near the anus
• May be considered in older or medically frail patients

This approach may offer a shorter recovery in selected patients, although recurrence rates can be higher than with abdominal repair.

Delorme Procedure

The Delorme procedure is a perineal operation used in selected cases, especially for shorter prolapse segments.

During this procedure:

• The inner lining of the prolapsed rectum is removed
• The muscle layer is folded and tightened
• The prolapse is shortened and reinforced

This may be considered when a less extensive perineal repair is appropriate.

Preparing for Rectal Prolapse Procedures

Preparation varies depending on the procedure.

Common preparation steps may include:

• Bowel preparation for colonoscopy or surgery
• Temporary adjustment of medications
• Review of constipation, incontinence, and pelvic floor symptoms
• Preoperative testing based on age and medical history

Your physician will provide detailed instructions before any diagnostic or surgical procedure.

Related Rectal Prolapse Pages

To learn more about rectal prolapse, visit these related topics:

• Rectal Prolapse Symptoms
• Conditions Related to Rectal Prolapse
• Rectal Prolapse Treatments
• Rectal Prolapse Resources

When to Seek Immediate Medical Care

Urgent evaluation is recommended if rectal prolapse occurs with:

• Severe pain
• Tissue that cannot be pushed back in
• Dark, dusky, or black discoloration of the prolapsed tissue
• Heavy bleeding
• Rapid worsening swelling

These symptoms may indicate incarceration or impaired blood supply and may require emergency treatment.

Expert Colorectal Evaluation in Phoenix

Procedures play a central role in confirming rectal prolapse, assessing pelvic floor function, and guiding the most appropriate treatment plan.

Dr. Aisha Akhtar provides expert evaluation and advanced colorectal procedures for patients with rectal prolapse in Phoenix, Scottsdale, and Glendale, Arizona.

📞 Appointment: 602-932-5660

Learn More About Rectal prolapse

You may also explore these guides:

• Rectal prolapse Overview
• Rectal prolapse Symptoms
• Rectal prolapse Procedures
• Rectal prolapse FAQ
• Rectal prolapse Images & Diagrams