Understanding Rectal Prolapse and Surgical Repair for Patients in Houston, TX

By Ritha Belizaire

Quick Insights

Rectal prolapse repair is surgery to reposition rectal tissue that has slipped through the anus. The rectum is secured back in place using abdominal or perineal techniques. Most patients experience symptom improvement, though recurrence can occur in some cases.

Surgical approach depends on your age, overall health, and specific anatomy. Consulting a healthcare professional can help determine the most appropriate treatment options for rectal prolapse.

Key Takeaways

• Abdominal approaches show lower recurrence rates than perineal procedures in comparative studies.
• Robot-assisted ventral mesh rectopexy improves continence in approximately 70% of patients.
• Recovery typically involves 2-4 weeks before returning to normal activities.
• Recurrence occurs in 5-15% of cases, depending on the surgical technique selected.

Why It Matters

Rectal prolapse can cause discomfort and bowel control issues, potentially impacting daily activities and quality of life. Understanding your surgical options helps you make informed decisions about treatment timing and approach. With proper evaluation and individualized repair selection, most patients regain bowel control and return to activities without ongoing embarrassment or physical limitation.

Introduction

As a board-certified colorectal surgeon serving Houston, I've helped many patients regain comfort and confidence after rectal prolapse repair. To learn more about my background and experience as a board-certified colorectal surgeon in Houston, you can visit my professional bio.

Rectal prolapse occurs when rectal tissue slips through the anus, causing discomfort, leakage, and embarrassment. This condition can cause discomfort and bowel control issues, potentially impacting daily activities and quality of life, but it's treatable with the right surgical approach.

Many patients delay evaluation because they feel uncomfortable discussing bowel symptoms, yet consulting a healthcare professional can help determine the most appropriate treatment options for rectal prolapse.

At Houston Community Surgical, I use minimally invasive techniques tailored to your specific anatomy and health status. Most patients return to normal activities within 2-4 weeks after surgery.

Understanding your options helps you make informed decisions about treatment timing and approach.

What Is Rectal Prolapse?

Rectal prolapse occurs when the rectum loses its normal attachment inside the pelvis and slides through the anal opening. In my Houston practice, I often see patients who initially thought they had hemorrhoids, only to discover the tissue protruding is actually the rectal wall. This condition develops gradually in most cases, though some patients notice sudden worsening after straining or lifting.

The rectum normally stays anchored by ligaments and muscles that weaken over time. When these support structures fail, the rectal wall begins to telescope downward.

Early prolapse may only occur during bowel movements, retracting afterward on its own. Advanced prolapse remains outside the body and requires manual repositioning.

Several factors increase your risk of developing this condition. Chronic constipation and repeated straining may contribute to weakening of pelvic floor muscles over time. Pregnancy and childbirth are factors that may contribute to rectal prolapse. Aging is associated with factors that may contribute to rectal prolapse.

Rectal prolapse is more common in older adults, potentially due to the combined effect of multiple risk factors.

Common Symptoms and When to Seek Evaluation in Houston

The most obvious symptom is visible tissue protruding from your anus. This tissue may appear red or pink and feel soft or firm. You might notice it only during bowel movements initially, but it can progress to being present all the time.

Many patients experience a sensation of incomplete emptying after bowel movements. You may feel like something is blocking the rectal opening or that you need to strain excessively. Mucus discharge is a symptom that can occur with rectal prolapse.

Fecal incontinence affects approximately 50-75% of patients with rectal prolapse. You might leak stool without warning or struggle to control gas. These symptoms worsen as the prolapse advances because the stretched anal sphincter muscles can't maintain their normal seal.

Bleeding occurs when the prolapsed tissue becomes irritated or ulcerated. You might see bright red blood on toilet paper or notice it coating your stool. While bleeding is usually minor, persistent blood loss can lead to anemia over time.

I recommend seeking evaluation when you first notice tissue protruding from your anus. Early assessment allows us to determine the extent of prolapse and discuss treatment options before symptoms worsen. Don't wait until incontinence or bleeding becomes severe—these problems are harder to reverse once they've been present for months or years.

How Rectal Prolapse Is Diagnosed

Diagnosis begins with a detailed discussion of your symptoms and medical history. I ask about bowel habits, straining patterns, previous surgeries, and childbirth history. Understanding how long symptoms have been present helps me gauge prolapse severity.

Physical examination confirms the diagnosis in most cases. I'll ask you to strain as if having a bowel movement while sitting on a commode. This maneuver demonstrates the full extent of tissue descent. I can then assess whether the prolapse involves only the rectal lining or the full thickness of the rectal wall.

Additional testing helps evaluate pelvic floor function and rule out other conditions. Colonoscopy ensures no polyps or tumors are present, since these can sometimes cause straining that worsens prolapse. I order this test for anyone over 45 or those with concerning symptoms like unexplained weight loss.

Defecography uses special X-rays taken during simulated bowel movements. This test shows exactly how your pelvic floor muscles and rectum move during straining. It reveals hidden prolapse that doesn't appear during office examination and identifies other problems like rectoceles or enteroceles.

Anorectal physiology testing measures sphincter muscle strength and rectal sensation. These results help predict which patients might benefit most from surgical repair and guide my choice of surgical technique. Houston-area patients can access these specialized diagnostic services to ensure accurate evaluation before treatment planning.

Surgical Repair Options for Houston Patients: What Research Shows

Surgical approaches fall into two main categories: abdominal and perineal. Abdominal procedures show lower recurrence rates than perineal approaches, though they require general anesthesia and slightly longer recovery. I select the approach based on your age, overall health, and specific anatomy.

Ventral mesh rectopexy has become my preferred abdominal technique for most patients. This robot-assisted procedureimproves continence in approximately 70% of patients while maintaining low complication rates. I use the robotic platform because it provides better visualization deep in the pelvis and allows precise mesh placement without excessive dissection.

The procedure involves lifting the rectum back into its normal position and securing it with a mesh strip attached to the sacrum. Long-term studies show recurrence rates around 5-15% with this technique, significantly lower than older methods. Most patients notice immediate improvement in their ability to control bowel movements.

Perineal procedures work well for elderly patients or those with significant medical problems that make abdominal surgery risky. These operations are performed through the anus without abdominal incisions. Recovery is faster, but recurrence rates are higher—typically 15-30% over five years.

Comparative studies help guide surgical selection by showing which techniques offer the best balance of safety and effectiveness for different patient groups. I review these options with each patient, explaining how their specific situation influences which approach makes the most sense.

If you are seeking specialized colorectal care for rectal prolapse repair or related conditions, I invite you to learn more about our comprehensive colorectal surgery services and expertise at Houston Community Surgical.

Fecal Incontinence and Advanced Therapy

Fecal incontinence remains a common and distressing symptom for many patients with pelvic floor disorders. For those who continue to experience leakage even after surgical repair, advanced options such as Axonics sacral neuromodulation for fecal incontinence can offer significant symptom control and improve quality of life.

Recovery and What to Expect After Surgery

Most patients stay in the hospital one to two nights after abdominal rectal prolapse repair. Pain is usually moderate and well-controlled with oral medications. I encourage walking the evening of surgery to reduce blood clot risk and promote bowel function recovery.

Bowel movements typically resume within two to three days after surgery. You might notice some urgency or frequency initially as your rectum adjusts to its new position. These symptoms improve gradually over several weeks. I recommend a high-fiber diet and adequate fluid intake to prevent constipation during healing.

You can return to light activities within one week and resume normal exercise after four weeks. Avoid heavy lifting over 10 pounds for six weeks to allow the mesh to incorporate properly. Most Houston patients return to work within two to three weeks, depending on job demands.

Continence improvement happens gradually over three to six months as swelling resolves and pelvic floor muscles strengthen. Some patients benefit from pelvic floor physical therapy to maximize functional recovery. I refer patients who continue experiencing leakage despite anatomic correction.

Long-term success depends partly on addressing factors that contributed to prolapse development. Managing constipation, maintaining a healthy weight, and avoiding excessive straining help prevent recurrence. I follow patients annually to monitor for any signs of prolapse returning and address concerns before they become significant problems.

A Patient's Perspective

As a colorectal surgeon, I've learned that patient experiences often teach me as much as medical journals do.

When someone trusts me with their care during a frightening time, I'm reminded why I chose this specialty. The review below reflects one patient's journey through diagnosis and treatment—a journey that required courage, trust, and partnership between patient and surgeon.

"My experience under the care of Dr. Ritha Belizaire has been nothing short of amazing. From the moment my wife and I walked into Dr. Belizaire's office, we were met with warmth and compassion. Her genuine concern for my well-being was palpable, alleviating many of the fears that had been weighing heavily on me. She drew out on paper for us, explaining exactly where my cancer was and how she was going to remove it. Her drawing was not very good. I hadn't laughed in a while, but she made me laugh when she assured me that she was a much better surgeon."

— Lechuga

This is one patient's experience; individual results may vary.

Every patient's path through colorectal surgery is unique, shaped by their specific diagnosis and personal circumstances. What remains constant is my commitment to explaining options clearly and supporting patients through each decision with honesty and respect.

Conclusion

Rectal prolapse repair offers meaningful relief when you're struggling with discomfort, leakage, and embarrassment that affect your daily life. Minimally invasive robotic techniques allow precise repair with faster recovery than traditional approaches, helping most patients return to normal activities within weeks.

I've seen how individualized surgical selection—matching technique to your anatomy, age, and health status—improves both safety and long-term outcomes. Understanding your options empowers you to make informed decisions about treatment timing rather than delaying care out of embarrassment.

Serving patients from Montrose to the Medical Center and surrounding Houston communities, I provide compassionate, evidence-based care at Houston Community Surgical. Whether you're in Montrose, near the Medical Center, or elsewhere in the Houston area, expert help is available.

If you're experiencing any of these symptoms, don't wait. Call my office at 832-979-5670 to request a prompt appointment. Not local? I also offer virtual second opinion case reviews at www.2ndscope.com—so no matter where you are, expert help is just a click away. Or, schedule a same-day consultation using our simple online request form.

Nearby facilities include the Texas Medical Center.

This article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

Frequently Asked Questions

What causes rectal prolapse to develop?

Rectal prolapse develops when pelvic floor muscles and ligaments weaken over time, allowing the rectum to slip through the anal opening. Chronic constipation and repeated straining may contribute to weakening of pelvic floor muscles over time.

Pregnancy and childbirth are factors that may contribute to rectal prolapse, while aging is associated with factors that may contribute to rectal prolapse. Rectal prolapse is more common in older adults, potentially due to the combined effect of multiple risk factors. Early evaluation helps determine whether conservative management or surgical repair offers the best approach for your specific situation.

How do I know if I need surgery for rectal prolapse?

Surgery becomes appropriate when prolapse causes persistent symptoms that affect your quality of life. You may need surgical repair if tissue remains outside your body, requiring manual repositioning, if you experience fecal incontinence that limits daily activities, or if conservative treatments like pelvic floor therapy haven't provided adequate relief.

I evaluate prolapse severity through physical examination and specialized testing to determine whether your anatomy and symptoms warrant surgical intervention. Most patients benefit from repair before incontinence becomes severe, since stretched sphincter muscles are harder to restore after prolonged prolapse.

What are the chances of rectal prolapse returning after surgery?

Recurrence ratesdepend on which surgical technique is selected for your repair. Abdominal approaches like ventral mesh rectopexy show recurrence rates around 5-15% over five years, while perineal procedures typically have higher recurrence rates of 15-30%. I select your surgical approach based on your age, overall health, and specific anatomy to balance safety with effectiveness.

Managing constipation, maintaining a healthy weight, and avoiding excessive straining after surgery help prevent prolapse from returning. I follow patients annually to monitor for any signs of recurrence and address concerns before they become significant problems.

Where can I find rectal prolapse repair in Houston?

Dr. Ritha Belizaire at Houston Community Surgical provides physician-led evaluation and treatment for rectal prolapse repair in Houston. My practice focuses on clear answers, respectful care, and evidence-based minimally invasive options.

If you're unsure what's causing your symptoms, scheduling a visit can help you understand the next steps and explore surgical approaches tailored to your specific situation.

For ongoing guidance and research highlights, subscribe to my colorectal health newsletter and stay updated on advances in pelvic floor surgery and rectal prolapse repair.