Rectal prolapse surgery repositions the rectum back into its correct anatomical location to restore proper pelvic floor function. This procedure relieves symptoms like pain, fecal incontinence, and obstructed defecation caused by the prolapse. Regardless of the surgical technique used (e.g., abdominal rectopexy or a perineal approach), a structured recovery period is necessary for successful healing and long-term results. Understanding the realistic expectations for the weeks and months following your operation is important for navigating the recovery process.
Immediate Post-Operative Care
The initial recovery phase takes place in the hospital, typically lasting between one and three days; an abdominal approach may require a slightly longer stay. Pain management begins immediately, often utilizing intravenous (IV) medication or patient-controlled analgesia (PCA) pumps for the first day. This transitions to oral pain medication once you are stable and able to tolerate liquids.
Hospital staff will continuously monitor your vital signs and incision sites, ensuring no signs of bleeding or infection develop. You may have a temporary urinary catheter in place for a day or two, especially after abdominal surgery, because the procedure can temporarily affect bladder function. The catheter is removed once you are able to empty your bladder completely on your own.
Early mobilization is encouraged, and you will be asked to walk short distances with assistance soon after the procedure. This initial activity is important for preventing complications like blood clots and stimulating the return of normal bowel function. Discharge generally occurs once you are passing gas, tolerating solid food, and your pain is well-controlled with oral medication.
Navigating Early Home Recovery
The first two to four weeks at home are crucial for physical healing and require specific restrictions. A major focus is protecting the surgical repair by avoiding any activity that increases pressure within the abdomen. You must refrain from heavy lifting, specifically anything weighing more than 10 pounds, for at least six weeks following the operation.
You must also limit other strenuous activities, including vigorous exercise and anything that requires forceful pushing or pulling. While brief, gentle walks are encouraged to aid circulation, avoid prolonged periods of sitting or standing, which can strain the pelvic floor. Most patients should not drive for about one week, or until they are no longer taking narcotic pain relievers and can safely operate the vehicle.
Managing the incision site involves keeping the area clean and dry, and you should avoid submerging the wound in a bath or pool for approximately two weeks. If the surgical site becomes irritated, a plain water sitz bath may be recommended. Fatigue is common during this time, and you should rest when needed. Returning to light, non-physical work generally ranges from two to four weeks.
Strategies for Bowel Management and Diet
Preventing constipation and subsequent straining is the highest priority during recovery, as straining stresses the surgical repair and increases recurrence risk. To achieve this, your diet must immediately shift to include high levels of fiber, aiming for approximately 25 to 35 grams daily. This bulk can be achieved through whole-grain foods, fresh fruits, vegetables, and fiber supplements like psyllium or methylcellulose.
Maintaining hydration is equally important, as it softens the stool and aids fiber movement through the digestive tract. Aim to drink eight to ten glasses of water or non-caffeinated fluids daily unless your physician advises otherwise. This combination of hydration and fiber creates a soft, manageable stool that passes easily without effort.
Your surgeon will likely prescribe a stool softener or a gentle laxative for the first several weeks, and it is important to take these as directed. Narcotic pain medication can worsen constipation, so proactively managing bowel movements is necessary. The first few bowel movements may feel difficult or slightly painful, but resist the urge to strain. You will be instructed on when to gradually reduce and discontinue the use of prescribed softeners as your bowel habits stabilize.
Monitoring for Complications and Long-Term Follow-Up
While many symptoms are normal during recovery, certain signs require immediate contact with your surgical team. You must monitor for indicators of infection, such as:
- A fever exceeding 101°F.
- Excessive redness or warmth at the incision site.
- Foul-smelling discharge.
Uncontrolled or severe pain that does not respond to prescribed medication, or heavy bleeding from the rectum or incision, also necessitate prompt medical attention.
Long-term success depends on a commitment to lifestyle changes that mitigate the risk of the prolapse returning. The overall recurrence rate following surgery is low, often cited between 2% and 5%, but chronic straining significantly increases this risk. Maintaining a high-fiber, high-hydration diet is the most effective long-term strategy to avoid this complication.
You will have scheduled post-operative follow-up appointments with your surgeon, typically within the first month and again around six to eight weeks after the procedure. These visits allow the surgical team to assess incision healing, ensure bowel function is normalizing, and address any ongoing concerns you may have. These appointments confirm the long-term integrity of the repair.