Rectal Prolapse Repair: Words for the Surgical Discussion

If your surgeon has proposed a perineal repair for diagnosed rectal prolapse, bring the bowel difficulties you want help with into the discussion. You may be thinking about leaving home without worrying about leakage, or about how hard it has become to use the toilet. Ask the surgeon to connect the proposed operation to those concerns before you consent.

Ask what the operation changes

A rectal prolapse involves the end of the bowel protruding through the anus. In a perineal repair, the bowel lining or the prolapsed section of bowel is removed and the bowel is stitched back together. Guy’s describes Delorme’s and Altemeier procedures.¹

“Which operation are you proposing for me? Please explain what you will remove and how that relates to the bowel problems I have described.”

Ask the surgeon to use a drawing if the explanation is hard to picture. Record the name of the procedure on the appointment sheet so that any further questions refer to the same operation.

Discuss why this approach fits

Treatment selection depends on the prolapse type, previous surgery and medical health. Other options described by Guy’s include specialist-taught bowel-emptying techniques and pelvic floor exercises, clinician-selected rectal irrigation, and an abdominal surgical approach.¹

“Why do you recommend this approach in my case? Which alternatives are reasonable for me, and what would each aim to improve?”

Tell the team about prior operations and what you have already tried. Ask what further assessment, if any, is needed before you decide. Have the surgeon explain the expected benefit and uncertainty for the option they recommend.

Bring bowel control into consent

Perineal repair can fail with another prolapse. Risks include anal narrowing and temporary or permanent bowel-control problems. A leak where the bowel is joined is a severe complication that can be life-threatening.¹

“Please explain the important risks for my operation, including recurrence and bowel control. How will you check recovery, and which symptoms require urgent help?”

Request the written aftercare plan, the urgent contact route and the planned review date. Ask the team to go through the full risks and recovery arrangements for your procedure, including any support you need at home.

Keep the decision and instructions together

Bring a support person if you want help remembering the discussion. Ask for clarification while deciding and keep the consent information with the operation name, contact numbers and appointment details.

Bloated by Dinner includes a visit script and Bristol scale card. Use them to organize bowel observations and questions alongside the surgeon’s assessment and care plan.