What are the symptoms of rectal prolapse. What causes rectal prolapse to occur. How is rectal prolapse diagnosed and treated. What are the different types of rectal prolapse. Who is at risk for developing rectal prolapse. What complications can arise from untreated rectal prolapse. How can rectal prolapse be prevented.

Understanding Rectal Prolapse: Definition and Types

Rectal prolapse is a condition where the rectum, the final portion of the large intestine, turns inside out and protrudes through the anus. This medical issue can significantly impact a person’s quality of life and requires proper understanding for effective management.

There are three main types of rectal prolapse:

• Internal prolapse: The rectum has prolapsed but hasn’t extended beyond the anus.
• Mucosal prolapse: Only the inner lining of the rectum protrudes through the anus.
• External prolapse: The entire thickness of the rectum extends outside the anus, also known as complete or full-thickness prolapse.

Is rectal prolapse a common condition? While not extremely common, rectal prolapse affects a significant number of people, particularly women and young children. Women are six times more likely to experience rectal prolapse compared to men. Additionally, children of both sexes under the age of three are also commonly affected, though in most cases, the condition resolves on its own without surgical intervention.

Recognizing the Symptoms of Rectal Prolapse

Identifying the symptoms of rectal prolapse is crucial for early diagnosis and treatment. The severity of symptoms can vary depending on the extent of the prolapse. Common signs and symptoms include:

• Pain and discomfort in the lower abdomen
• Blood and mucus discharge from the anus
• Feeling of incomplete bowel emptying
• Difficulty passing bowel movements
• Visible protrusion of rectal tissue through the anus
• Excessive use of toilet paper for cleaning after bowel movements
• Leakage of liquid feces, especially after defecation
• Fecal incontinence or reduced bowel control

Can rectal prolapse occur without visible protrusion? Yes, in the early stages or in cases of internal prolapse, the rectum may slip out during bowel movements but retract on its own without visible external protrusion.

Exploring the Causes and Risk Factors of Rectal Prolapse

While the exact cause of rectal prolapse remains unknown, several risk factors have been identified that may contribute to its development:

1. Chronic constipation and straining during bowel movements
2. Weakened pelvic floor muscles
3. Weakened anal sphincter muscles
4. Advanced age (more common in people 65 years and older)
5. Genetic predisposition
6. Parasitic infections (rare in developed countries)
7. Conditions that increase abdominal pressure (e.g., benign prostatic hypertrophy, chronic obstructive pulmonary disease)
8. Structural issues with rectal ligaments
9. Congenital bowel problems (e.g., Hirschsprung’s disease, neuronal intestinal dysplasia)
10. Previous lower back trauma or disc disease

Does childbirth increase the risk of rectal prolapse? While not directly mentioned in the original text, childbirth can weaken the pelvic floor muscles, potentially increasing the risk of rectal prolapse in women.

Diagnosing Rectal Prolapse: Methods and Considerations

Accurate diagnosis of rectal prolapse is essential for determining the appropriate treatment approach. The diagnostic process typically involves:

• Physical examination: The doctor may ask the patient to bear down to observe the prolapse, especially if it retracts on its own after bowel movements.
• Imaging tests: For suspected internal prolapse, ultrasound or special x-rays may be used.
• Anorectal manometry: This test measures the muscle activity in the anus and rectum.
• Additional tests: If rectal bleeding is present, further tests may be conducted to rule out other conditions such as bowel cancer.

Are there any specific tests for children with rectal prolapse? Yes, it’s important to note that about 11% of children with rectal prolapse have cystic fibrosis. Therefore, testing for this condition is crucial in young patients presenting with rectal prolapse.

Differential Diagnosis

When diagnosing rectal prolapse, healthcare providers must consider other conditions that may present with similar symptoms. These may include:

• Hemorrhoids
• Anal fissures
• Rectal polyps
• Colorectal cancer

Treatment Options for Rectal Prolapse

The treatment approach for rectal prolapse depends on various factors, including the patient’s age, the severity of the prolapse, and the presence of other pelvic abnormalities. Treatment options include:

1. Conservative management:
   • Dietary and lifestyle changes to address chronic constipation
   • Increased intake of fruits, vegetables, and whole grains
   • Adequate hydration
   • Regular exercise
2. Non-surgical interventions:
   • Securing mucosal prolapse with surgical rubber bands
3. Surgical treatment:
   • Abdominal approach
   • Perineal approach (via the anus)

Is surgery always necessary for treating rectal prolapse? No, surgery is not always required. In young children, dietary and lifestyle changes to address constipation are often sufficient to resolve the prolapse without surgical intervention.

Surgical Approaches for Rectal Prolapse

When surgery is deemed necessary, two main approaches are considered:

• Abdominal approach: This method involves making incisions in the abdomen to access and secure the rectum in place. It may be performed as open surgery or laparoscopically.
• Perineal approach: This technique involves operating through the anus, avoiding abdominal incisions. It’s often preferred for older or higher-risk patients.

The choice of surgical approach depends on various factors, including the patient’s overall health, age, and the severity of the prolapse.

Complications and Prognosis of Rectal Prolapse

If left untreated, rectal prolapse can lead to several complications:

• Damage to the rectum, including ulceration and bleeding
• Incarceration: The prolapsed rectum cannot be manually pushed back inside
• Strangulation: Reduced blood supply to the prolapsed rectum
• Gangrene: Death and decay of the strangulated rectal tissue

What is the long-term outlook for patients with rectal prolapse? With proper treatment, the prognosis for rectal prolapse is generally good. Surgical interventions have high success rates, and many patients experience significant improvement in their quality of life. However, recurrence is possible, especially if underlying risk factors are not addressed.

Recurrence and Follow-up Care

After treatment, particularly following surgery, it’s essential for patients to:

• Attend regular follow-up appointments
• Maintain a high-fiber diet and stay well-hydrated
• Perform pelvic floor exercises as recommended
• Avoid straining during bowel movements

These measures can help prevent recurrence and maintain long-term bowel health.

Prevention Strategies for Rectal Prolapse

While not all cases of rectal prolapse can be prevented, certain strategies may help reduce the risk:

1. Maintain a healthy diet rich in fiber to prevent constipation
2. Stay adequately hydrated
3. Exercise regularly to strengthen pelvic floor muscles
4. Avoid straining during bowel movements
5. Practice good toilet habits, including not spending excessive time on the toilet
6. Manage chronic cough or other conditions that increase abdominal pressure
7. Perform Kegel exercises to strengthen pelvic floor muscles

Can pelvic floor exercises help prevent rectal prolapse? Yes, regularly performing pelvic floor exercises, such as Kegel exercises, can help strengthen the muscles supporting the rectum and potentially reduce the risk of prolapse.

Special Considerations for Pediatric Rectal Prolapse

Rectal prolapse in children requires special attention and management. Key points to consider include:

• Higher prevalence in children under three years of age
• Often resolves spontaneously without surgical intervention
• Dietary modifications are usually the first-line treatment
• Importance of screening for cystic fibrosis
• Parental education on proper toileting habits and diet

How does the management of rectal prolapse differ in children compared to adults? In children, especially those under three, conservative management through dietary changes is often sufficient. Surgery is generally reserved for cases that don’t respond to conservative measures or in older children with persistent prolapse.

Cystic Fibrosis Screening

Given the association between rectal prolapse and cystic fibrosis in children, it’s crucial to conduct appropriate screening tests. This may include:

• Sweat chloride test
• Genetic testing for cystic fibrosis mutations
• Lung function tests in older children

Early detection of cystic fibrosis can lead to better management of both conditions.

Psychological Impact and Quality of Life Considerations

Rectal prolapse can significantly impact a person’s quality of life and psychological well-being. Patients may experience:

• Embarrassment and social anxiety
• Depression due to chronic discomfort and lifestyle limitations
• Reduced self-esteem and body image issues
• Relationship difficulties, particularly regarding intimacy
• Work-related challenges due to symptoms and treatment requirements

How can healthcare providers address the psychological aspects of rectal prolapse? Healthcare providers should adopt a holistic approach to care, which may include:

• Providing comprehensive patient education
• Offering psychological support or referrals to mental health professionals
• Encouraging participation in support groups
• Addressing concerns about body image and intimacy
• Collaborating with social workers to address practical lifestyle challenges

By addressing both the physical and psychological aspects of rectal prolapse, healthcare providers can help patients achieve better overall outcomes and improved quality of life.

Emerging Research and Future Directions in Rectal Prolapse Management

The field of rectal prolapse management continues to evolve, with ongoing research aimed at improving diagnosis, treatment, and patient outcomes. Some areas of current interest include:

• Advanced imaging techniques for more accurate diagnosis
• Minimally invasive surgical approaches, including robotic-assisted procedures
• Novel biomaterials for rectal support and repair
• Stem cell therapies for strengthening pelvic floor muscles
• Personalized treatment algorithms based on genetic and lifestyle factors

What promising advancements are on the horizon for rectal prolapse treatment? While not explicitly mentioned in the original text, emerging research in regenerative medicine and tissue engineering shows potential for developing new treatment modalities. These may include:

• Bioengineered rectal support structures
• Gene therapy approaches to address underlying genetic predispositions
• Advanced biofeedback techniques for pelvic floor rehabilitation
• Neuroplasticity-based therapies to improve rectal muscle function

As research progresses, these innovative approaches may offer new hope for patients with rectal prolapse, potentially leading to more effective and less invasive treatment options in the future.

The Role of Multidisciplinary Care

Given the complex nature of rectal prolapse and its potential impact on various aspects of a patient’s life, a multidisciplinary approach to care is increasingly recognized as beneficial. This may involve collaboration between:

• Colorectal surgeons
• Gastroenterologists
• Pelvic floor physiotherapists
• Nutritionists
• Psychologists or psychiatrists
• Urologists (for associated pelvic floor disorders)
• Gynecologists (for female patients with concurrent pelvic organ prolapse)

By bringing together expertise from various specialties, healthcare providers can offer more comprehensive and personalized care to patients with rectal prolapse, addressing not only the primary condition but also any associated complications or comorbidities.

Rectal prolapse – Better Health Channel

Actions for this page

Summary

Read the full fact sheet

• We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
• Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
• A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

The rectum is the last 20 cm or so of the large bowel. It is the temporary storage area for bowel motions. Rectal prolapse occurs when the rectum turns itself inside out and comes out through the anus. Without treatment, the rectum will eventually need to be pushed back in manually.

Women are six times more likely to suffer rectal prolapse than men. Children of both sexes under the age of three years are also commonly affected by rectal prolapse, although the prolapse tends to resolve by itself without the need for surgery.

In the early stages of rectal prolapse, a portion of the rectum slips out while passing a bowel motion, but it goes back inside by itself.

Symptoms of rectal prolapse

The symptoms of rectal prolapse depend on the severity, but can include:

• Pain and discomfort felt deep within the lower abdomen
• Blood and mucus from the anus
• The feeling of constipation, or that the rectum is never completely emptied after passing a motion
• Difficulties passing a bowel motion
• Protrusion of the rectum through the anus
• The need to use huge quantities of toilet paper to clean up following a bowel motion
• Leakage of liquefied faeces, particularly following a bowel motion
• Faecal incontinence, or reduced ability to control the bowels.

Types of rectal prolapse

Rectal prolapse is graded according to its severity, including:

• Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
• Mucosal prolapse – the interior lining of the rectum protrudes through the anus
• External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.

Causes of rectal prolapse

The exact cause of rectal prolapse is unknown, but risk factors include:

• Chronic constipation
• Straining to pass bowel motions
• Weakened pelvic floor muscles
• Weakened anal sphincter muscles
• Weakening of the muscles associated with ageing, since rectal prolapse is more common in people aged 65 years and over
• Genetic susceptibility, since it appears that some people with rectal prolapse have a blood relative with the same condition
• Parasitic infection, such as schistosomiasis – very rare in Australia
• Any condition that chronically increases pressure within the abdomen, such as benign prostatic hypertrophy, or chronic obstructive pulmonary disease (COPD)
• Structural problems with the ligaments that tether the rectum to its surrounds
• Congenital problems of the bowel, such as Hirschsprung’s disease or neuronal intestinal dysplasia
• Prior trauma to the lower back
• Disc disease in the lower back.

Complications of rectal prolapse

Complications of rectal prolapse include:

• Risk of damage to the rectum, such as ulceration and bleeding
• Incarceration – the rectum can’t be manually pushed back inside the body
• Strangulation of the rectum – the blood supply is reduced
• Death and decay (gangrene) of the strangulated section of the rectum.

Diagnosis of rectal prolapse

Rectal prolapse is diagnosed by examination. In cases where the rectum goes back inside by itself after passing a bowel motion, the person may have to bear down during examination by the doctor to show the prolapse in order to confirm the diagnosis.

In cases of suspected internal prolapse, diagnostic tests may include ultrasound, special x-rays and measurement of the anorectal muscle activity (anorectal manometry). If the person has experienced rectal bleeding, the doctor may want to do a number of tests to check for other conditions such as bowel cancer.

About 11 per cent of children with rectal prolapse have cystic fibrosis, so it is important to test young people for this condition too.

Treatment for rectal prolapse

Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present (such as prolapsed bladder). Treatment options can include:

• Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
• Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse
• Surgery.

Surgery for rectal prolapse

Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus. One operation involves tethering the rectum to the central bone of the pelvis (sacrum). Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.

Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.

Before surgery for rectal prolapse

The day before surgery, you will be asked to fast, and may need to drink a special preparation to help flush out your bowels. Once you are in hospital, the anaesthetist will visit you to see what sort of anaesthetic is best for you. You may be given medication in the hours before the operation to prepare you for anaesthesia and make you feel drowsy.

Rectal prolapse operation procedure

The various types of surgery include:

• Laparotomy (open abdominal surgery) – the surgeon uses a single, large incision (cut) in the abdomen. Then the surgeon carefully moves aside the overlying organs. To stop the rectum prolapsing, it is lifted, pulled straight and stitched directly to the inner surface of the sacrum (central bone of the pelvis). Sometimes, a short length of bowel may be removed
• Laparoscopy (keyhole abdominal surgery) – laparoscopy may be possible in some cases. This involves inserting slender instruments through a number of small incisions in the abdomen. Recovery time following laparoscopy is usually quicker than open surgery
• Anal surgery – under anaesthesia, the surgeon gently pulls out the prolapsed bowel through the anus. The prolapsed section of bowel is usually removed and the structural damage repaired. The bowel is rejoined and returned back through the anus to restore normal bowel function and appearance.

Other forms of treatment for rectal prolapse

Surgery is the best option for severe rectal prolapse. Other possible forms of treatment may include:

• Lifestyle changes – including high-fibre diet, drinking plenty of water and getting regular exercise
• Change to toileting habits – such as not straining when trying to pass a bowel motion. This may require using fibre supplements or laxatives.

Immediately after surgery for rectal prolapse

After your operation for rectal prolapse or rectocele, things you can expect include:

• Hospital staff will observe and note your temperature, pulse, breathing and blood pressure.
• You will have an intravenous fluid line in your arm to replace fluids in your body.
• You will receive pain-relieving medications. Tell your nurse if you need more pain relief.
• You may have a catheter to drain off urine for the next day or so, or until you can empty your bladder by yourself.
• If you have a vaginal pack, this will be taken out later the same day or the day after surgery.
• You may be in hospital for three to six days following surgery.
• You will need to make follow-up appointments with your doctor.

Complications of surgery for rectal prolapse

Possible complications of surgery include:

• Allergic reaction to the anaesthetic
• Haemorrhage
• Infection
• Injury to nearby nerves or blood vessels
• Damage to other pelvic organs, such as the bladder or rectum
• Death (necrosis) of the rectal wall
• Recurrence of the rectal prolapse.

Taking care of yourself at home after surgery for rectal prolapse

Be guided by your doctor, but general suggestions include:

• Rest as much as you can.
• Avoid heavy lifting or straining for a few weeks.
• Don’t strain on the toilet.
• Take measures to prevent constipation, such as eating high-fibre foods and drinking plenty of water.
• After rectocele surgery, expect bloody vaginal discharge for about four weeks.
• Contact your doctor if you experience any unusual symptoms, such as difficulties with urination, heavy bleeding, fever, or signs of infection around the wound sites.
• You can expect to return to work around six weeks after surgery.
• Attend follow-up appointments with your surgeon.

Long-term outlook after surgery for rectal prolapse

While surgery through the abdomen gives better results, older people may be advised to undergo surgical correction of rectal prolapse via the anus, since this procedure is less stressful on the body.

Surgery gives good results in most cases of rectal prolapse, but some people may find that symptoms such as constipation or the inability to completely empty the bowels continue.

Unfortunately for women with rectocele, the problem will recur after surgery in about 10 per cent of cases.

Where to get help

• Your doctor
• Colorectal or general surgeon

Things to remember

• We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
• Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
• A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

This page has been produced in consultation with and approved
by:

This page has been produced in consultation with and approved
by:

Give feedback about this page

Was this page helpful?

More information

Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 30-09-2014

Rectal prolapse – Better Health Channel

Actions for this page

Summary

Read the full fact sheet

• We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
• Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
• A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

The rectum is the last 20 cm or so of the large bowel. It is the temporary storage area for bowel motions. Rectal prolapse occurs when the rectum turns itself inside out and comes out through the anus. Without treatment, the rectum will eventually need to be pushed back in manually.

Women are six times more likely to suffer rectal prolapse than men. Children of both sexes under the age of three years are also commonly affected by rectal prolapse, although the prolapse tends to resolve by itself without the need for surgery.

In the early stages of rectal prolapse, a portion of the rectum slips out while passing a bowel motion, but it goes back inside by itself.

Symptoms of rectal prolapse

The symptoms of rectal prolapse depend on the severity, but can include:

• Pain and discomfort felt deep within the lower abdomen
• Blood and mucus from the anus
• The feeling of constipation, or that the rectum is never completely emptied after passing a motion
• Difficulties passing a bowel motion
• Protrusion of the rectum through the anus
• The need to use huge quantities of toilet paper to clean up following a bowel motion
• Leakage of liquefied faeces, particularly following a bowel motion
• Faecal incontinence, or reduced ability to control the bowels.

Types of rectal prolapse

Rectal prolapse is graded according to its severity, including:

• Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapse
• Mucosal prolapse – the interior lining of the rectum protrudes through the anus
• External prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.

Causes of rectal prolapse

The exact cause of rectal prolapse is unknown, but risk factors include:

• Chronic constipation
• Straining to pass bowel motions
• Weakened pelvic floor muscles
• Weakened anal sphincter muscles
• Weakening of the muscles associated with ageing, since rectal prolapse is more common in people aged 65 years and over
• Genetic susceptibility, since it appears that some people with rectal prolapse have a blood relative with the same condition
• Parasitic infection, such as schistosomiasis – very rare in Australia
• Any condition that chronically increases pressure within the abdomen, such as benign prostatic hypertrophy, or chronic obstructive pulmonary disease (COPD)
• Structural problems with the ligaments that tether the rectum to its surrounds
• Congenital problems of the bowel, such as Hirschsprung’s disease or neuronal intestinal dysplasia
• Prior trauma to the lower back
• Disc disease in the lower back.

Complications of rectal prolapse

Complications of rectal prolapse include:

• Risk of damage to the rectum, such as ulceration and bleeding
• Incarceration – the rectum can’t be manually pushed back inside the body
• Strangulation of the rectum – the blood supply is reduced
• Death and decay (gangrene) of the strangulated section of the rectum.

Diagnosis of rectal prolapse

Rectal prolapse is diagnosed by examination. In cases where the rectum goes back inside by itself after passing a bowel motion, the person may have to bear down during examination by the doctor to show the prolapse in order to confirm the diagnosis.

In cases of suspected internal prolapse, diagnostic tests may include ultrasound, special x-rays and measurement of the anorectal muscle activity (anorectal manometry). If the person has experienced rectal bleeding, the doctor may want to do a number of tests to check for other conditions such as bowel cancer.

About 11 per cent of children with rectal prolapse have cystic fibrosis, so it is important to test young people for this condition too.

Treatment for rectal prolapse

Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present (such as prolapsed bladder). Treatment options can include:

• Diet and lifestyle changes to treat chronic constipation – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children
• Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse
• Surgery.

Surgery for rectal prolapse

Surgery is sometimes used to secure the rectum into place. It can be performed through the person’s abdomen or via their anus. One operation involves tethering the rectum to the central bone of the pelvis (sacrum). Another operation is to remove the prolapsed part of the rectum and to rejoin the bowel to restore near-normal bowel function.

Although surgery through the abdomen may give better long-term results, older people may be advised to undergo surgical correction via the anus, since it is easier to recover from this procedure.

Before surgery for rectal prolapse

The day before surgery, you will be asked to fast, and may need to drink a special preparation to help flush out your bowels. Once you are in hospital, the anaesthetist will visit you to see what sort of anaesthetic is best for you. You may be given medication in the hours before the operation to prepare you for anaesthesia and make you feel drowsy.

Rectal prolapse operation procedure

The various types of surgery include:

• Laparotomy (open abdominal surgery) – the surgeon uses a single, large incision (cut) in the abdomen. Then the surgeon carefully moves aside the overlying organs. To stop the rectum prolapsing, it is lifted, pulled straight and stitched directly to the inner surface of the sacrum (central bone of the pelvis). Sometimes, a short length of bowel may be removed
• Laparoscopy (keyhole abdominal surgery) – laparoscopy may be possible in some cases. This involves inserting slender instruments through a number of small incisions in the abdomen. Recovery time following laparoscopy is usually quicker than open surgery
• Anal surgery – under anaesthesia, the surgeon gently pulls out the prolapsed bowel through the anus. The prolapsed section of bowel is usually removed and the structural damage repaired. The bowel is rejoined and returned back through the anus to restore normal bowel function and appearance.

Other forms of treatment for rectal prolapse

Surgery is the best option for severe rectal prolapse. Other possible forms of treatment may include:

• Lifestyle changes – including high-fibre diet, drinking plenty of water and getting regular exercise
• Change to toileting habits – such as not straining when trying to pass a bowel motion. This may require using fibre supplements or laxatives.

Immediately after surgery for rectal prolapse

After your operation for rectal prolapse or rectocele, things you can expect include:

• Hospital staff will observe and note your temperature, pulse, breathing and blood pressure.
• You will have an intravenous fluid line in your arm to replace fluids in your body.
• You will receive pain-relieving medications. Tell your nurse if you need more pain relief.
• You may have a catheter to drain off urine for the next day or so, or until you can empty your bladder by yourself.
• If you have a vaginal pack, this will be taken out later the same day or the day after surgery.
• You may be in hospital for three to six days following surgery.
• You will need to make follow-up appointments with your doctor.

Complications of surgery for rectal prolapse

Possible complications of surgery include:

• Allergic reaction to the anaesthetic
• Haemorrhage
• Infection
• Injury to nearby nerves or blood vessels
• Damage to other pelvic organs, such as the bladder or rectum
• Death (necrosis) of the rectal wall
• Recurrence of the rectal prolapse.

Taking care of yourself at home after surgery for rectal prolapse

Be guided by your doctor, but general suggestions include:

• Rest as much as you can.
• Avoid heavy lifting or straining for a few weeks.
• Don’t strain on the toilet.
• Take measures to prevent constipation, such as eating high-fibre foods and drinking plenty of water.
• After rectocele surgery, expect bloody vaginal discharge for about four weeks.
• Contact your doctor if you experience any unusual symptoms, such as difficulties with urination, heavy bleeding, fever, or signs of infection around the wound sites.
• You can expect to return to work around six weeks after surgery.
• Attend follow-up appointments with your surgeon.

Long-term outlook after surgery for rectal prolapse

While surgery through the abdomen gives better results, older people may be advised to undergo surgical correction of rectal prolapse via the anus, since this procedure is less stressful on the body.

Surgery gives good results in most cases of rectal prolapse, but some people may find that symptoms such as constipation or the inability to completely empty the bowels continue.

Unfortunately for women with rectocele, the problem will recur after surgery in about 10 per cent of cases.

Where to get help

• Your doctor
• Colorectal or general surgeon

Things to remember

• We do not know the exact cause of rectal prolapse, but risk factors include chronic constipation, straining to pass bowel motions, and weakened pelvic floor muscles.
• Treatment includes surgery, performed through the abdomen or via the anus, to tether the rectum into place.
• A diet that successfully treats constipation is often all that’s needed to cure rectal prolapse in young children.

This page has been produced in consultation with and approved
by:

This page has been produced in consultation with and approved
by:

Give feedback about this page

Was this page helpful?

More information

Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 30-09-2014

Rectal prolapse – methods of treatment, stages of prolapse, symptoms and complications

Prices Doctors Our centers

Classification Symptoms Complications Diagnosis Treatment methods Prognosis Prevention

Rectal prolapse or rectal prolapse is a pathological condition
which is accompanied by the release of the mucosa beyond the boundaries of the anal sphincter. All layers of the diastal layer fall out
segment of the large intestine. The protruding segment in this case ranges from 2 to 20 centimeters and even more.

Often this disease is diagnosed in men, they account for 70% of clinical cases. In 30% pathology
occurs in women. Prolapse is predominantly formed in people of working age from 20 to 50 years, however
often occurs in babies 3-4 years old due to the specifics of the anatomical and physiological characteristics of the child
organism.

Causes of weakening of muscles and ligaments, which leads to prolapse of rectal nodes:

• hereditary predisposition;
• incorrect anatomical structure of the pelvic bones, shape and rectum and sigmoid colon, intestinal wall;
• prolonged defecation disorders: diarrhoea, constipation;
• excessive straining during urination;
• parasitic intestinal infections;
• injuries of pelvic nerves and muscles;
• regular excessive physical activity, hard work, heavy lifting;
• heavy or multiple childbirth in women;
• diseases of the nervous system.

Classification

The official classification of human rectal prolapse is used by specialists when developing a therapeutic
scheme. It provides for the distribution of pathology into three stages:

• Stage 1 (compensated) – the intestine falls out only during defecation and returns on its own
  in a natural position;
• stage 2 (subcompensated) – prolapse occurs during bowel movements and at high
  physical exertion, accompanied by insufficiency of the anal sphincter;
• stage 3 (decompensated) – prolapse of the rectum is observed even when walking, coughing, sneezing,
  accompanied by incontinence of feces, gases, severe insufficiency of the sphincter.

Specialists also distinguish two types of rectal prolapse:

• Hernia – Douglas pouch and anterior wall of the rectum move down, with weak muscles
  pelvic floor and constant high intra-abdominal pressure lead to prolapse of the intestine into the anal canal. Through
  time, all the walls are involved in the pathological process, and the sagging increases.
• Invaginated or internal prolapse – part of the rectum or sigmoid colon is embedded in the lumen
  other part of the intestine. In this case, the organ does not go outside, and the main symptom of pathology is regular
  strong pain attacks.

Symptoms

Symptoms of pathology occur both gradually and suddenly. An unexpected start is associated with sharp and intense
loads, stress. After such an episode, the rectum falls out, and the person feels sharp pains in the abdomen, up to
to pain shock.

More often, however, rectal prolapse develops gradually. As the pathology progresses, it becomes more
pronounced and signs of loss:

• sensation of a foreign body in the anus;
• abdominal pain that worsens with walking, exercise, defecation;
• incontinence, inability to hold back gases, stools;
• frequent false urge to defecate;
• sensation of incomplete bowel movements;
• frequent urination;
• secretion of mucus, blood from the anus;
• the formation of a solitary ulcer, mucosal edema (with internal prolapse).

Complications in the absence of treatment

The most dangerous complication that occurs when ignoring prolapse is the infringement of the prolapsed segment of the intestine.
Infringement appears with untimely intervention or when you try to set the prolapse on your own.
Accompanied by edema, increasing ischemia, impaired blood supply. If you do not seek help in time,
the outer portion of the tissues will be affected by necrosis (tissue necrosis).

Another complication that pathology leads to is solitary ulcers. Such wounds cause over time
bleeding leading to perforation.

In advanced stages of internal prolapse, acute intestinal obstruction and peritonitis often occur. These are dangerous
conditions that pose a threat to human life.

Promotion! Free consultation with a surgeon about surgery

Take advantage of this unique opportunity and get a free consultation about elective surgery.

Diagnostics

A proctologist can diagnose rectal prolapse and the degree of bowel prolapse even without examination and analysis
symptoms. The prolapsed part of the organ has a cone-shaped, cylindrical or spherical shape, painted in
bright red or bluish tint. The mucous membrane is markedly swollen and bleeds on contact. On
in the early stages, you can set the intestine and restore the normal state of the tissues. If at the time of examination the prolapse is not
observed, the patient is offered to strain to provoke a prolapse.

During a digital examination, the doctor determines the tone of the sphincter, differentiates the disease from hemorrhoids and anal
polyps. After that, for an accurate diagnosis, identification of complications and the exact stage of the disease,
instrumental diagnostics, which includes:

• colonoscopy – to identify the causes of the pathology;
• barium enema – to detect functional changes in the colon;
• defectography (proctography) – to determine the degree of prolapse;
• anorectal manometry – to assess muscle function;
• endoscopic examination (sigmoidoscopy) – to detect intussusception, the presence of ulcers;
• endoscopic biopsy with tissue examination – is prescribed if a solitary ulcer is detected to exclude
  oncology of the rectum;
• gynecological examination – for women.

Methods of treatment of rectal prolapse

Conservative approaches are used only in the earliest stages of the disease. The main purpose of such events is
normalize stool and eliminate increased intra-abdominal pressure. Clinical recommendations include:

• high fiber diet;
• drinking plenty of water;
• laxatives;
• drugs to increase peristalsis;
• neurostimulation, which helps to regain control of the muscles in case of impaired innervation.

Surgical methods of treatment bring results in the later stages of the development of prolapse, as well as in cases where
when conservative therapy fails. There are many operations that help get rid of
pathology. They include:

• excision of the prolapsed section of the rectum;
• bowel fixation;
• plastic surgery of the anal canal, pelvic floor;
• colon resection;
• combined methods.

Resection of the prolapsed section is more often done predominantly by surgery
Delorme. The surgeon removes the mucous membrane and forms a new muscle layer in the anal canal area. Operation
has a low invasiveness and is suitable even for older patients with serious chronic pathologies.
Less commonly, resection of the prolapsed lobe is done by patchwork cutting according to Nelaton or circular removal according to Mikulich.

Among fixation methods, rectopexy is considered the most effective –
an operation in which the pelvic section of the intestine is attached to the walls of the pelvis, thus restoring the correct
organ anatomy. The operation is performed on patients under 50-55 years of age. In 97% of cases, organ prolapse is eliminated.

Anal plastic surgery helps narrow the anus with surgical sutures and wires,
synthetic materials. However, this group of methods has a high risk of recurrence, so it is rarely used.

Resection of the distal colon is necessary if the patient has a solitary ulcer or necrosis. Often
such an operation is combined with fixing operations.

SM-Clinic surgeons have experience in performing various types of prolapse surgery. Our clinicians in
are fluent in modern surgical techniques and successfully help patients get rid of pathological
bowel prolapse.

Forecast

Surgical treatment brings a positive result without recurrence in 80% of cases. In 70-75% of patients, as a result
treatment restores the evacuation capacity of the intestine. At the same time, 25-30% of patients develop disorders
transitory function.

Moreover, the earlier the patient seeks help, the more favorable the prognosis will be. Unfortunately, patients often go to
doctor only in the later stages of the development of pathology, when prolapse is already obvious, bowel functions are impaired, and in
tissues began to undergo irreversible changes. In this case, the risk of developing life-threatening complications increases in
times.

Prophylaxis

To prevent the disease, as well as to prevent relapse, doctors recommend eliminating factors that increase
intra-abdominal pressure and cause weakness of the pelvic floor muscles:

• avoid injuries in the pelvis, sacrum;
• physical activity, stress;
• treat constipation, flatulence, diarrhea;
• do not start urolithiasis, prostate adenoma;
• to prevent hacking agonizing cough.

Pathology develops as a result of a combination of several factors, so for prevention it is necessary to minimize all
risks.

Specialists in this field 21 doctors

Leading doctors 6 doctors

Petrushina Marina Borisovna

Surgeon, proctologist

Work experience: 42 years

Udarnikov, 19

m. Ladozhskaya

Make an appointment

Aramyan David Surenovich

Surgeon, coloproctologist, oncologist, mammologist

Work experience: 13 years Reception

Yaroslav Viktorovich Kolosovsky

Surgeon, mammologist, oncologist

Work experience: 17 years

Dybenko, 13k4

m. Dybenko Street

Sign up for an appointment

Karapetyan Zaven Surenovich

coloproctologist, surgeon and phlebologist

Work experience: 15 years

Dunaisky, 47

Dunayskaya metro station

Marshala Zakharov, 20

Leninskiy avenue metro station

Make an appointment 90 003 Andrey Shishkin

Surgeon, phlebologist, proctologist. Candidate of Medical Sciences

Work experience: 13 years

Dunaysky, 47

Dunayskaya metro station

Make an appointment

Maslennikov Dmitry Yurievich

Surgeon, proctologist, mammologist

Work experience: 16 years

Udarnikov, 19

Ladozhskaya metro station

Dybenko, 13k4

Dybenko street metro

Make an appointment

Show more
+15 doctors

Other doctors 15 doctors

Ardashov, Pavel Sergeevich

Coloproctologist-surgeon

Work experience: 9 years

Udarnikov, 19

persons Dybenko

Make an appointment

Bulkina Maria Sergeevna

Coloproctologist, surgeon

Work experience: 11 years

Dunaysky, 47

Dunayskaya metro station

Vyborgskoe shosse, 17

Prosveshcheniya metro station 9000 3

Make an appointment

Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

m.
Klyuev Andrey

Operating proctologist

Work experience: 16 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Nekrasov Roman Aleksandrovich

Coloproctologist and surgeon

Work experience: 8 years

Udarnikov, 19

Ladozhskaya metro station

Marshala Zakharov, 20

Leninsky pr. -t

Make an appointment

Petrova Vitalina Vasilievna

Operating proctologist

Work experience: 12 years

Vyborgskoe shosse, 17

Prospekt Prosveshcheniya metro station

Make an appointment

Senko Vladimir Vladimirovich

Head of the Center for Surgery and Oncology

Work experience: 23 years Leninsky Prospekt

Vyborgskoe shosse, 17

m Prospect Prosveshcheniya

Make an appointment

Sinyagina (Nazarova) Maria Andreevna

Surgeon, proctologist

Work experience: 8 years

Marshala Zakharova, 20

06
Sokolova Anna Sergeevna

Coloproctologist, surgeon. Candidate of Medical Sciences.

Work experience: 13 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Sol Anton Aleksandrovich

Work experience: 15 years

Vyborgskoye shosse, 17

metro Prosveshcheniya

Make an appointment

Fomenko Nikolai Aleksandrovich

Surgeon, proctologist, oncologist

Work experience: 15 years

Marshal Zakharova, 20

m. Leninsky pr-t

Sign up for reception

Khangireev Alexander Bakhytovich

Surgeon, oncologist, coloproctologist

Work experience: 13 years

Udarnikov, 19

Ladozhskaya metro station

Dunaiskiy, 47

Dunaiskaya metro station

Make an appointment

Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 years old

Vyborg highway, 17

m. Prospekt Prospect

Sign up for reception

Chuprina Susanna Vladimirovna

Coloproctologist of the highest category

Work experience: 22 years

Udarnikov, 19

Ladozhskaya metro station

Make an appointment

Yalda Ksenia Davidovna

Coloproctologist

Work experience: 11 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Hide the list 90 003

Our offices in St.

Petersburg

6 branches

Center for Surgery Dunayskaya metro station

47 Dunaisky prospect

Dunaiskaya metro station

daily from 09:00 to 22:00

Surgery Center Ladozhskaya metro station

Udarnikov Avenue, 19/1

Ladozhskaya metro station

daily from 09:00 to 22:00

Center for Surgery Metro station “Leninsky Prospekt”

st. Marshal Zakharov, d.
daily from 09:00 to 22:00

Center for Surgery Prospekt Prosveshcheniya metro station

Vyborgskoe shosse, 17 building 1

Prospect Prosveshcheniya metro station

daily from 09:00 to 22:00

Surgery Center Kupchino metro station

Malaya Balkanskaya street, 23

Kupchino metro station

daily from 09:00 to 22:00

Center for Surgery Dybenko Street

Dybenko Street, 13k4

m. Dybenko street

daily from 09:00 to 22:00

Rectal prolapse – methods of treatment, stages of prolapse, symptoms and complications

Prices Doctors Our centers

Classification Symptoms Complications Diagnosis Treatment methods Prognosis Prevention

Rectal prolapse or rectal prolapse is a pathological condition
which is accompanied by the release of the mucosa beyond the boundaries of the anal sphincter. All layers of the diastal layer fall out
segment of the large intestine. The protruding segment in this case ranges from 2 to 20 centimeters and even more.

Often this disease is diagnosed in men, they account for 70% of clinical cases. In 30% pathology
occurs in women. Prolapse is predominantly formed in people of working age from 20 to 50 years, however
often occurs in babies 3-4 years old due to the specifics of the anatomical and physiological characteristics of the child
organism.

Causes of weakening of muscles and ligaments, which leads to prolapse of rectal nodes:

• hereditary predisposition;
• incorrect anatomical structure of the pelvic bones, shape and rectum and sigmoid colon, intestinal wall;
• prolonged defecation disorders: diarrhoea, constipation;
• excessive straining during urination;
• parasitic intestinal infections;
• injuries of pelvic nerves and muscles;
• regular excessive physical activity, hard work, heavy lifting;
• heavy or multiple childbirth in women;
• diseases of the nervous system.

Classification

The official classification of human rectal prolapse is used by specialists when developing a therapeutic
scheme. It provides for the distribution of pathology into three stages:

• Stage 1 (compensated) – the intestine falls out only during defecation and returns on its own
  in a natural position;
• stage 2 (subcompensated) – prolapse occurs during bowel movements and at high
  physical exertion, accompanied by insufficiency of the anal sphincter;
• stage 3 (decompensated) – prolapse of the rectum is observed even when walking, coughing, sneezing,
  accompanied by incontinence of feces, gases, severe insufficiency of the sphincter.

Specialists also distinguish two types of rectal prolapse:

• Hernia – Douglas pouch and anterior wall of the rectum move down, with weak muscles
  pelvic floor and constant high intra-abdominal pressure lead to prolapse of the intestine into the anal canal. Through
  time, all the walls are involved in the pathological process, and the sagging increases.
• Invaginated or internal prolapse – part of the rectum or sigmoid colon is embedded in the lumen
  other part of the intestine. In this case, the organ does not go outside, and the main symptom of pathology is regular
  strong pain attacks.

Symptoms

Symptoms of pathology occur both gradually and suddenly. An unexpected start is associated with sharp and intense
loads, stress. After such an episode, the rectum falls out, and the person feels sharp pains in the abdomen, up to
to pain shock.

More often, however, rectal prolapse develops gradually. As the pathology progresses, it becomes more
pronounced and signs of loss:

• sensation of a foreign body in the anus;
• abdominal pain that worsens with walking, exercise, defecation;
• incontinence, inability to hold back gases, stools;
• frequent false urge to defecate;
• sensation of incomplete bowel movements;
• frequent urination;
• secretion of mucus, blood from the anus;
• the formation of a solitary ulcer, mucosal edema (with internal prolapse).

Complications in the absence of treatment

The most dangerous complication that occurs when ignoring prolapse is the infringement of the prolapsed segment of the intestine.
Infringement appears with untimely intervention or when you try to set the prolapse on your own.
Accompanied by edema, increasing ischemia, impaired blood supply. If you do not seek help in time,
the outer portion of the tissues will be affected by necrosis (tissue necrosis).

Another complication that pathology leads to is solitary ulcers. Such wounds cause over time
bleeding leading to perforation.

In advanced stages of internal prolapse, acute intestinal obstruction and peritonitis often occur. These are dangerous
conditions that pose a threat to human life.

Promotion! Free consultation with a surgeon about surgery

Take advantage of this unique opportunity and get a free consultation about elective surgery.

Diagnostics

A proctologist can diagnose rectal prolapse and the degree of bowel prolapse even without examination and analysis
symptoms. The prolapsed part of the organ has a cone-shaped, cylindrical or spherical shape, painted in
bright red or bluish tint. The mucous membrane is markedly swollen and bleeds on contact. On
in the early stages, you can set the intestine and restore the normal state of the tissues. If at the time of examination the prolapse is not
observed, the patient is offered to strain to provoke a prolapse.

During a digital examination, the doctor determines the tone of the sphincter, differentiates the disease from hemorrhoids and anal
polyps. After that, for an accurate diagnosis, identification of complications and the exact stage of the disease,
instrumental diagnostics, which includes:

• colonoscopy – to identify the causes of the pathology;
• barium enema – to detect functional changes in the colon;
• defectography (proctography) – to determine the degree of prolapse;
• anorectal manometry – to assess muscle function;
• endoscopic examination (sigmoidoscopy) – to detect intussusception, the presence of ulcers;
• endoscopic biopsy with tissue examination – is prescribed if a solitary ulcer is detected to exclude
  oncology of the rectum;
• gynecological examination – for women.

Methods of treatment of rectal prolapse

Conservative approaches are used only in the earliest stages of the disease. The main purpose of such events is
normalize stool and eliminate increased intra-abdominal pressure. Clinical recommendations include:

• high fiber diet;
• drinking plenty of water;
• laxatives;
• drugs to increase peristalsis;
• neurostimulation, which helps to regain control of the muscles in case of impaired innervation.

Surgical methods of treatment bring results in the later stages of the development of prolapse, as well as in cases where
when conservative therapy fails. There are many operations that help get rid of
pathology. They include:

• excision of the prolapsed section of the rectum;
• bowel fixation;
• plastic surgery of the anal canal, pelvic floor;
• colon resection;
• combined methods.

Resection of the prolapsed section is more often done predominantly by surgery
Delorme. The surgeon removes the mucous membrane and forms a new muscle layer in the anal canal area. Operation
has a low invasiveness and is suitable even for older patients with serious chronic pathologies.
Less commonly, resection of the prolapsed lobe is done by patchwork cutting according to Nelaton or circular removal according to Mikulich.

Among fixation methods, rectopexy is considered the most effective –
an operation in which the pelvic section of the intestine is attached to the walls of the pelvis, thus restoring the correct
organ anatomy. The operation is performed on patients under 50-55 years of age. In 97% of cases, organ prolapse is eliminated.

Anal plastic surgery helps narrow the anus with surgical sutures and wires,
synthetic materials. However, this group of methods has a high risk of recurrence, so it is rarely used.

Resection of the distal colon is necessary if the patient has a solitary ulcer or necrosis. Often
such an operation is combined with fixing operations.

SM-Clinic surgeons have experience in performing various types of prolapse surgery. Our clinicians in
are fluent in modern surgical techniques and successfully help patients get rid of pathological
bowel prolapse.

Forecast

Surgical treatment brings a positive result without recurrence in 80% of cases. In 70-75% of patients, as a result
treatment restores the evacuation capacity of the intestine. At the same time, 25-30% of patients develop disorders
transitory function.

Moreover, the earlier the patient seeks help, the more favorable the prognosis will be. Unfortunately, patients often go to
doctor only in the later stages of the development of pathology, when prolapse is already obvious, bowel functions are impaired, and in
tissues began to undergo irreversible changes. In this case, the risk of developing life-threatening complications increases in
times.

Prophylaxis

To prevent the disease, as well as to prevent relapse, doctors recommend eliminating factors that increase
intra-abdominal pressure and cause weakness of the pelvic floor muscles:

• avoid injuries in the pelvis, sacrum;
• physical activity, stress;
• treat constipation, flatulence, diarrhea;
• do not start urolithiasis, prostate adenoma;
• to prevent hacking agonizing cough.

Pathology develops as a result of a combination of several factors, so for prevention it is necessary to minimize all
risks.

Specialists in this field 21 doctors

Leading doctors 6 doctors

Petrushina Marina Borisovna

Surgeon, proctologist

Work experience: 42 years

Udarnikov, 19

m. Ladozhskaya

Make an appointment

Aramyan David Surenovich

Surgeon, coloproctologist, oncologist, mammologist

Work experience: 13 years Reception

Yaroslav Viktorovich Kolosovsky

Surgeon, mammologist, oncologist

Work experience: 17 years

Dybenko, 13k4

m. Dybenko Street

Sign up for an appointment

Karapetyan Zaven Surenovich

coloproctologist, surgeon and phlebologist

Work experience: 15 years

Dunaisky, 47

Dunayskaya metro station

Marshala Zakharov, 20

Leninskiy avenue metro station

Make an appointment 90 003 Andrey Shishkin

Surgeon, phlebologist, proctologist. Candidate of Medical Sciences

Work experience: 13 years

Dunaysky, 47

Dunayskaya metro station

Make an appointment

Maslennikov Dmitry Yurievich

Surgeon, proctologist, mammologist

Work experience: 16 years

Udarnikov, 19

Ladozhskaya metro station

Dybenko, 13k4

Dybenko street metro

Make an appointment

Show more
+15 doctors

Other doctors 15 doctors

Ardashov, Pavel Sergeevich

Coloproctologist-surgeon

Work experience: 9 years

Udarnikov, 19

persons Dybenko

Make an appointment

Bulkina Maria Sergeevna

Coloproctologist, surgeon

Work experience: 11 years

Dunaysky, 47

Dunayskaya metro station

Vyborgskoe shosse, 17

Prosveshcheniya metro station 9000 3

Make an appointment

Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

m.
Klyuev Andrey

Operating proctologist

Work experience: 16 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Nekrasov Roman Aleksandrovich

Coloproctologist and surgeon

Work experience: 8 years

Udarnikov, 19

Ladozhskaya metro station

Marshala Zakharov, 20

Leninsky pr. -t

Make an appointment

Petrova Vitalina Vasilievna

Operating proctologist

Work experience: 12 years

Vyborgskoe shosse, 17

Prospekt Prosveshcheniya metro station

Make an appointment

Senko Vladimir Vladimirovich

Head of the Center for Surgery and Oncology

Work experience: 23 years Leninsky Prospekt

Vyborgskoe shosse, 17

m Prospect Prosveshcheniya

Make an appointment

Sinyagina (Nazarova) Maria Andreevna

Surgeon, proctologist

Work experience: 8 years

Marshala Zakharova, 20

06
Sokolova Anna Sergeevna

Coloproctologist, surgeon. Candidate of Medical Sciences.

Work experience: 13 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Sol Anton Aleksandrovich

Work experience: 15 years

Vyborgskoye shosse, 17

metro Prosveshcheniya

Make an appointment

Fomenko Nikolai Aleksandrovich

Surgeon, proctologist, oncologist

Work experience: 15 years

Marshal Zakharova, 20

m. Leninsky pr-t

Sign up for reception

Khangireev Alexander Bakhytovich

Surgeon, oncologist, coloproctologist

Work experience: 13 years

Udarnikov, 19

Ladozhskaya metro station

Dunaiskiy, 47

Dunaiskaya metro station

Make an appointment

Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 years old

Vyborg highway, 17

m. Prospekt Prospect

Sign up for reception

Chuprina Susanna Vladimirovna

Coloproctologist of the highest category

Work experience: 22 years

Udarnikov, 19

Ladozhskaya metro station

Make an appointment

Yalda Ksenia Davidovna

Coloproctologist

Work experience: 11 years

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment

Hide the list 90 003

Our offices in St.