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Rectal Prolapse Repair Surgery: Success Rates, Approaches, and Recovery

Rectal Prolapse: Surgical Management

Rectal prolapse = full-thickness rectal wall protrusion through anus. Surgery is definitive treatment; success rates 80–90% for symptom resolution.

Surgical Approaches

ApproachDescriptionBest For
Perineal (Altemeier / Delorme)Via anus/perineum; no abdominal incisionElderly, high surgical risk, comorbidities
Abdominal (Resection Rectopexy / Suture Rectopexy)Laparoscopic/open; resect redundant sigmoid, fix rectum to sacrumHealthy patients; lower recurrence
Transanal (STARR / TREPP)Stapled/transanal resectionInternal intussusception, rectocele

Common Complications

  • Bleeding, infection, anastomotic leak (abdominal).
  • Urinary retention, sexual dysfunction.
  • New/worsened constipation or incontinence.
  • Recurrence (5–15% at 5 years; higher with perineal).

Postoperative Course

  • Hospital stay: 2–5 days (abdominal), 1–3 days (perineal).
  • Pain control, stool softeners, high fiber, hydration.
  • No heavy lifting >6 weeks.
  • Pelvic floor PT often beneficial.

Outcomes

Most patients achieve durable symptom relief. Choice depends on age, fitness, prolapse type, surgeon expertise. Shared decision-making essential.

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