Rectal Prolapse

Rectal prolapse occurs when the rectum falls out of its natural position. Virginia Mason Franciscan Health is among the few programs in the Puget Sound region where highly skilled colorectal surgeons, gastroenterologists and urogynecologists collaborate to deliver seamless care. We use proven methods that help more patients maintain lasting symptom relief.

Rectal prolapse is a complex condition that often involves multiple pelvic organs. The most effective care comes from programs like ours that treat a high volume of cases. We offer advanced testing and the latest treatments. Our depth of experience gives you the best chances for excellent outcomes. Meet our team.

Highlights of our program include: 

• Trusted experts: Our highly skilled team includes urogynecologists, gastroenterologists and colorectal surgeons. Our specialists have completed advanced fellowship training, and some are leading innovation through research. You can count on us for effective treatment tailored to your needs. 

• Advanced assessments: We offer video defecography with fluoroscopy. This sophisticated study provides information we can’t obtain with other methods. It accurately pinpoints the source of your symptoms so that you receive appropriate treatment. 

• Nonsurgical treatments: If you have mild rectal prolapse, symptoms may improve without surgery. Virginia Mason Franciscan Health offers every available option, including pelvic floor physical therapy and new treatments available through clinical trials. Learn more about nonsurgical pelvic floor treatments.

• Minimally invasive surgery: We typically operate through small incisions so you experience a quicker, more comfortable recovery. Our surgeons have vast experience in robot-assisted procedures that offer an exceptional level of precision. Find out more about surgery for pelvic floor disorders.

In addition to the rectum not being in its natural position, you may experience:

• Anal pain, itching or bleeding      
• Difficulty initiating bowel movements
• Leakage of bowel contents (fecal incontinence)
• Rectal bleeding
• Rectal tissue passing through the anus, especially during physical activity
• Sensation that your rectum is not empty after a bowel movement

Rectal prolapse is often due to a weak pelvic floor (network of muscles that support the bladder, bowels and uterus). Pelvic floor weakness can lead to additional issues, such as:

• Chronic constipation      
• Fecal incontinence 
• Pelvic organ prolapse, which means organs such as your bladder, vagina and uterus slip out of position
• Rectocele and enterocele, types of prolapse affecting the wall separating the rectum or small intestine and vagina

A thorough exam and diagnostic testing help us determine the severity of rectal prolapse so that you receive appropriate treatments. We offer a full range of tests, including: 

• Defecography, which helps to identify structural issues with your pelvic floor 
• Manometry, which detects functional issues with the pelvic floor muscles and nerves 

Get more information about diagnostic testing for pelvic floor disorders.

Nonsurgical options are for mild prolapse and may prevent symptoms from worsening. Treatment may include diet and lifestyle changes, pelvic floor physical therapy or pessaries (insertable devices that support your pelvic organs). Nutritionists, gastroenterologists, psychologists and specially trained physical therapists help you achieve the best possible results

Colorectal surgeons with additional training in pelvic floor disorders offer every available prolapse repair option. Their expertise includes advanced options, such as robotic rectopexy, to return the rectum to its natural place in the pelvis. This procedure is performed through the abdomen with or without mesh or bowel resection. Surgeons can also repair other types of pelvic prolapse, including vaginal prolapse, at the same time.  

Sometimes, your surgeon may use procedures that involve incisions around the rectum (perineal area) instead of the abdomen. They will let you know which approach is best for you. If prolapse affects multiple organ systems, other specialists may participate in your procedure. Learn more about rectal prolapse surgery.

Our multidisciplinary team of pelvic health specialists cares for patients across the Puget Sound area and beyond. Contact us to learn more or to schedule an appointment.