Rectal Prolapse Surgery (Rectopexy)

Rectal prolapse is when the rectum turns inside out and protrudes through the anus, usually on straining and eventually on standing or walking. Surgery either lifts the rectum from above and fixes it to the sacrum (rectopexy) or removes the prolapsing bowel from below (perineal procedures).

Repair stops the protrusion, mucus leakage and bleeding and often improves bowel control. It does not always restore continence, because a long-standing prolapse may have stretched the sphincter, and constipation can persist or occasionally worsen.

What Rectal Prolapse Surgery (Rectopexy) involves

In the most common operation for fit adults, laparoscopic or robotic ventral mesh rectopexy, the surgeon works through small abdominal cuts. The front of the rectum is freed down to the pelvic floor while the nerves at the back and sides are left undisturbed. A strip of mesh is stitched to the front of the rectum and anchored to the sacral promontory, holding the rectum up. The lining of the abdomen is closed over the mesh. In perineal operations, done with your legs in stirrups, the prolapse is pulled out fully; either its lining is stripped and the muscle pleated (Delorme) or the full-thickness segment is removed and the ends joined (Altemeier).

Who is a good candidate for Rectal Prolapse Surgery (Rectopexy)?

Almost everyone with a full-thickness prolapse benefits from repair; the choice of operation depends on age, fitness and bowel habit.

• Adults with a full-thickness prolapse confirmed on examination
• People with internal prolapse causing obstructed defaecation who have failed pelvic floor physiotherapy
• Frail or elderly patients, who can have a perineal repair under spinal anaesthesia
• Women with combined rectal and vaginal vault prolapse, who may have both fixed in one operation

It is usually not the right choice if:

• Prolapsing haemorrhoids mistaken for rectal prolapse, which need different treatment
• Children, in whom prolapse nearly always settles with treatment of constipation
• People with untreated severe constipation or slow-transit colon, who need assessment first
• Anyone unwilling to accept mesh should discuss suture rectopexy or perineal options

Technique options

• Laparoscopic or robotic ventral mesh rectopexy: First choice in many centres for fit patients. Low recurrence of around 5 percent and tends to improve rather than worsen constipation.
• Suture or posterior rectopexy, with or without sigmoid resection: No mesh. Resection is added when there is marked constipation with a long, redundant sigmoid colon.
• Delorme procedure: Perineal repair for short prolapses in frail patients. Gentle on the body, but recurrence of 15 to 30 percent.
• Altemeier procedure (perineal rectosigmoidectomy): For longer prolapses in high-risk patients, or a strangulated prolapse.

What happens during your treatment

Abdominal rectopexy takes 1.5 to 3 hours under general anaesthesia; perineal repairs take about an hour and can be done under spinal anaesthesia. You wake with a urinary catheter for a day. Pain after keyhole surgery is modest. The first bowel movement, usually on day 2 or 3, can feel strange but should not be very painful.

Preparing for your trip

Plan for 8 to 12 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Hospital stay is 1 to 3 nights after keyhole rectopexy and 2 to 4 after perineal repair. Laxatives are taken for at least 6 weeks, and straining and lifting over about 5 kilograms must be avoided for that time so the fixation can heal. Light work is possible at 2 weeks. Continence often continues to improve for 6 to 12 months, helped by pelvic floor physiotherapy.

• Back to everyday activity: 2 to 4 weeks
• When results show: Prolapse corrected immediately
• How long they last: Long-lasting; recurrence 5 to 30 percent by technique

Safety, risks and revision policy

Most people recover smoothly, but the pelvis is a confined area and specific problems can occur.

• Recurrence of the prolapse, from about 5 percent after mesh rectopexy to 30 percent after Delorme repair
• New or worsened constipation, particularly after posterior rectopexy
• Mesh erosion into the rectum or vagina, or mesh infection, in around 1 to 2 percent
• Anastomotic leak after operations that remove bowel
• Bleeding from veins in front of the sacrum
• Persistent faecal incontinence needing further treatment
• Pelvic nerve injury affecting sexual or bladder function, which is uncommon

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Rectal Prolapse Surgery (Rectopexy) in Türkiye

Clinic-Y does not publish a single price for Rectal Prolapse Surgery (Rectopexy), because the honest figure depends on your case. What moves it:

• Abdominal or perineal approach, and whether the robot is used
• Type of mesh (synthetic or biological)
• Pre-operative tests such as defaecating proctogram, anorectal manometry and colonoscopy
• Length of hospital stay
• Combined gynaecological prolapse repair

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions