Rectal Prolapse Treatment after Natural Childbirth

When a woman gives birth naturally, the normal attachments of the rectum to the lower backbone may get stretched or torn. This tearing allows the rectum to fall into the pelvis which can lead to rectum prolapse. If your rectal prolapse is severe enough and interferes with your quality of life, your healthcare provider will probably recommend surgery.

Abdominal and rectal (also called perineal) surgery are the two most common approaches to rectal prolapse repair.

Abdominal repair approaches

Abdominal procedure refers to making an incision in the abdominal muscles to view and operate in the abdominal cavity. It is usually performed under general anesthesia and is the approach most often used in healthy adults. The two most common types of abdominal repair are rectopexy (fixation [reattachment] of the rectum) and resection (removal of a segment of intestine) followed by rectopexy. Resection is preferred for patients with severe constipation. Rectopexy can also be performed laparoscopically through small key-hole incisions or robotically.

Rectal (perineal) repair approaches

Rectal procedures are often used in older patients and in patients with more medical problem. Spinal anesthesia or an epidural may be used instead of general anesthesia in these patients. The two most common rectal approaches are the Altemeier and Delorme procedures.

Altemeier procedure

In this procedure — also called a perineal proctosigmoidectomy – the portion of the rectum extending out of the anus is cut off (amputated) and the two ends are sewn back together. The remaining structures that help support the rectum are stitched back together in an attempt to provide better support.

Delorme procedure

In this procedure, only the inner lining of the fallen rectum is removed. The outer layer is then folded and stitched and the cut edges of the inner lining are stitched together so that rectum is now inside of the anal canal.


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