Rectal Prolapse

Rectal Prolapse: Restoring Comfort, Function, and Peace of Mind

At the Intimate Wellness Institute of Virginia, we understand that the symptoms of rectal prolapse can be incredibly difficult, uncomfortable, and embarrassing to discuss. The feeling of severe pressure, bulging, or the inability to fully empty or control your bowels can profoundly impact your daily life and confidence.

We want you to know that we have created a safe, expert, and completely non-judgmental space to address these concerns. Our entire team is here to listen with compassion and provide the world-class surgical solutions that can give you your life back.

Understanding Rectal Prolapse

What is Happening in My Body?

Your rectum is the final section of your large intestine. It is held in place by a network of muscles and strong connective tissues. Rectal prolapse occurs when these attachments weaken or fail, causing the rectum to slide out of its normal position and protrude from the anus, especially during a bowel movement. While some tissue weakening is normal with age, a full rectal prolapse is not, and it requires medical intervention. It most commonly affects women over 50, particularly after childbirth.

Is It Rectal Prolapse or Hemorrhoids?

This is a very common and important question. While both can cause discomfort and a feeling of bulging, there are key differences:

Hemorrhoids are swollen blood vessels. They often cause itching and pain and may resolve on their own with home care.

Rectal Prolapse is a failure of the rectum’s support system. It is a chronic condition that will not go away on its own and is often associated with much greater difficulty passing stool, constipation, pain, and leakage of mucus or feces.

Symptoms and Why Early Treatment is Important

The signs of rectal prolapse can range from mild to severe, including:

• A feeling of pressure or bulging in your anus, or the sense that you are “sitting on a ball.”
• A reddish, fleshy mass that comes out of the anus, especially with straining.
• Persistent leakage of mucus, blood, or stool (fecal incontinence).
• The feeling that you cannot completely empty your bowels.

While not typically a life-threatening emergency, leaving rectal prolapse untreated can lead to significant complications. As the anal muscles continue to weaken, fecal incontinence often worsens, affecting up to 75% of people with the condition. The constant friction can cause painful rectal ulcers and bleeding. In rare cases, the prolapsed rectum can become “incarcerated” (stuck outside the body) and lose its blood supply, which is a surgical emergency.

Your Path to an Accurate Diagnosis at IWI

A precise diagnosis is the first step toward the right solution. Dr. Guerette and the IWI team will begin with a thorough review of your medical history and a gentle physical exam.

Because the entire pelvic floor is an interconnected system, Dr. Guerette will also check for co-existing conditions like bladder or uterine prolapse. This holistic approach ensures we create a comprehensive treatment plan that addresses all of your issues at once. To get a complete picture of your muscle and nerve function, we may use advanced imaging studies or tests to see precisely how your rectum and pelvic muscles are working.

Your Surgical Solution: A Specialized Approach

For adults, surgery is the only way to permanently fix rectal prolapse. At IWI, we specialize in the most advanced, minimally invasive techniques to provide the most durable and successful repair.

Dr. Guerette’s Preferred Method: Advanced Robotic Rectopexy

The best approach is a procedure called a rectopexy, which restores the rectum to its proper anatomical position. Dr. Guerette is the most experienced minimally-invasive robotic pelvic reconstructive surgeon in the region and has perfected a robotic rectopexy technique that is significantly less invasive and more successful than older methods.

Using the da Vinci® Robotic System, he makes tiny incisions in the abdomen to meticulously re-establish the supportive ligaments of the rectum, often using a specialized graft and knotless sutures. This advanced, minimally invasive technique provides a 97% long-term success rate, restoring normal function with less pain and a much faster recovery than traditional surgery.

Other Surgical Options (Perineal Approach)

For women who may not be ideal candidates for abdominal surgery, a repair can be performed through the anus (a perineal approach). These procedures, such as the Altemeier or Delorme procedure, can be effective for smaller prolapses or specific patient circumstances. Dr. Guerette will discuss all appropriate options with you to select the safest and most effective path for your individual needs.

Life After Surgery: Prevention and Long-Term Success

Our commitment to your well-being extends beyond the operating room. To protect your surgical repair and ensure long-term success, we emphasize strengthening your pelvic floor. Our comprehensive pelvic floor physical therapy and Emsella™ programs are critical components of your recovery and future health. We also provide guidance on preventing chronic constipation and diarrhea to protect your results for years to come.

The IWI Commitment

The IWI team understands how devastating rectal prolapse can be and how difficult it is to seek help for such a personal issue. We are here to make you comfortable, provide answers, and get you better.

You do not have to live with these symptoms. A definitive, expert solution is available right here in our Virginia center.

Contact The Intimate Wellness Institute of Virginia today to schedule your private, compassionate consultation with Dr. Guerette. Let us guide you on your journey to restoring your function, confidence, and peace of mind.