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Rectal prolapse surgery - the right repair, the right approach.

Repair of full-thickness rectal prolapse - laparoscopic or robotic ventral mesh rectopexy, resection rectopexy, or perineal Delorme’s and Altemeier’s procedures. A consultant pelvic-floor colorectal surgeon, honest mesh counselling, continence review built in.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private rectal prolapse surgery costs in the UK.

Indicative ranges across our partner pelvic-floor units.

In short

£9,000–£14,000, home in 2–4 nights.

Procedure Indicative range
Laparoscopic ventral mesh rectopexy £9,000–£14,000
Robotic-assisted ventral mesh rectopexy £12,000–£16,000
Laparoscopic resection rectopexy £10,000–£15,000
Delorme’s procedure (perineal) £8,000–£12,000
Altemeier’s (perineal rectosigmoidectomy) £9,000–£13,000
Anorectal physiology + defaecating proctography £450–£900
Colorectal consultation only £250–£450

Prices vary by hospital, by the consultant, by approach (abdominal or perineal), and by whether mesh is used. Robotic and resection cases sit at the top of the range.

The problem

The right diagnosis, the right approach, the right mesh conversation.

Rectal prolapse is where general colorectal quietly under-delivers - mucosal prolapse gets a rectopexy, perineal patients get an abdominal operation, mesh is either avoided out of fear or used without discussion.

  • Is it really full-thickness?

    Concentric folds means full-thickness prolapse. Radial folds mean mucosal prolapse or haemorrhoids - a different, smaller operation.

  • Abdominal or perineal - fitness dictates

    A young fit patient usually gets an abdominal repair. A frail older patient usually gets a perineal one. It is a joint decision, not a default.

  • Mesh with informed consent, or no mesh

    Post-Cumberlege UK practice: honest counselling on mesh, non-mesh alternatives on the table, and long-term follow-up if mesh is used.

When it helps

When rectal prolapse surgery is the right step.

The situations we see most, plus the red flag that means emergency assessment rather than a routine booking.

  • Full-thickness rectal prolapse

    The full thickness of the rectum coming through the anus - concentric folds, often on straining, sometimes lying down. The core indication for surgery.

  • Older women - the largest group

    Most cases are in women over 60, often with a history of childbirth, chronic straining or previous pelvic surgery. A pelvic-floor problem, not just a rectal one.

  • Younger patients - the other group

    A smaller cohort of younger patients - sometimes men - with dyssynergic defaecation or connective tissue issues. Careful assessment before surgery is essential.

  • Faecal incontinence with prolapse

    Continence deteriorates as the prolapse stretches the sphincter. Repairing the prolapse often improves - but does not always cure - the leakage.

  • Obstructed defaecation and internal prolapse

    An internal (occult) rectal prolapse causing incomplete emptying, straining and vaginal splinting - a different, more nuanced decision, often physiotherapy first.

  • Recurrence after previous prolapse surgery

    A previous perineal or abdominal repair that has failed - the choice of second procedure is dictated by what was done before.

  • Mucosal prolapse - a different problem

    Radial folds, mucosa only, no full-thickness bowel. Usually managed with banding, haemorrhoidectomy or minor procedures rather than a rectopexy.

  • Red flag: strangulated or irreducible prolapse

    A prolapse that will not go back in, is dusky, painful or bleeding needs emergency surgical assessment - A&E, not a routine referral.

Procedure options

Abdominal or perineal, with or without mesh.

What each option involves - approach (laparoscopic, robotic, perineal) and technique (ventral mesh rectopexy, resection rectopexy, Delorme’s, Altemeier’s).

  • Ventral mesh rectopexy (laparoscopic or robotic)

    The most common modern abdominal approach in the UK. A biological or synthetic mesh sling is attached to the front of the rectum and to the sacrum, lifting without full mobilisation. Low recurrence, good functional outcomes in experienced hands.

  • Resection rectopexy

    Rectopexy combined with removal of the redundant sigmoid colon. Useful where constipation is a dominant symptom. No mesh required in a suture-only version.

  • Suture rectopexy (no mesh)

    The rectum is mobilised and sutured to the sacrum without any mesh. Considered where patients wish to avoid mesh entirely.

  • Delorme’s procedure

    A perineal operation - the prolapsed mucosa is stripped and the underlying muscle plicated. Good for frail patients, shorter length of stay, higher recurrence than abdominal repair.

  • Altemeier’s (perineal rectosigmoidectomy)

    The full thickness of prolapsed bowel is resected through the anus and rejoined. Suits larger prolapses in older or comorbid patients unfit for abdominal surgery.

  • Anal encirclement (Thiersch)

    A very rare, historical option - a synthetic band around the anus. Occasionally used in the very frail; not first-line in modern UK practice.

  • Perineal versus abdominal - how we choose

    Fitness, age, prolapse size, bowel function and previous surgery all matter. Younger fit patients usually get an abdominal repair; frail patients usually a perineal one.

  • Mesh versus no mesh - post-Cumberlege

    Ventral mesh rectopexy uses posterior-approach abdominal mesh - different from vaginal mesh which has been paused in the UK. Choice, consent and long-term follow-up are the standard.

Safety and recovery

What to expect afterwards - honestly.

Rectal prolapse surgery is well established. The things worth planning are the approach, the mesh decision, and the continence and physio follow-up.

  • GA in a proper theatre, with a colorectal team

    Abdominal cases are under general anaesthetic. Perineal cases can be under GA or spinal. Day-case is unusual - most patients stay 1–4 nights depending on approach.

  • Bleeding and injury to nearby structures

    Bleeding, and injury to ureter, bladder, presacral veins or bowel each occur in under 2 percent of cases. The team is set up to recognise and repair on the table.

  • Infection, DVT and PE

    Wound and pelvic infection under 5 percent. DVT prophylaxis (stockings, heparin, early mobilisation) is standard. Call the same day for fever, calf pain or breathlessness.

  • Recurrence rates differ by approach

    Ventral mesh rectopexy: around 3–10 percent at 5 years. Delorme’s: 15–25 percent. Altemeier’s: 10–20 percent.

  • Continence and constipation change

    Continence usually improves after prolapse repair, but not always. Constipation can be a new issue after abdominal rectopexy - laxatives, diet and pelvic floor physio all help.

  • Mesh - erosion, pain, chronic issues

    Rare but real. Anterior-approach abdominal mesh has a much better safety profile than the vaginal mesh paused in the UK, but any mesh needs consent, follow-up and honest counselling.

  • Sexual function

    Dyspareunia, altered sensation or vaginal changes are possible after any pelvic surgery. We ask about baseline function and expect a specific discussion at consent.

  • Anastomotic leak (resection or Altemeier’s)

    A join is created in resection rectopexy and in Altemeier’s. Leak rate under 5 percent. Fever, rising pain or unusual output need same-day review.

  • Red flags after surgery

    Fever, spreading redness, no bowel action for 3+ days with pain, heavy bleeding, breathlessness or calf pain need the same-day team or A&E, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever approach was used - abdominal or perineal - the note the surgeon sends you keeps to the same shape.

A UK consultant colorectal surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the follow-up plan before your review, just ask.

  1. 01 Header

    Indication, prolapse type and approach

    Why the operation was done, whether it was full-thickness or internal, and whether the approach was abdominal (laparoscopic or robotic) or perineal (Delorme’s, Altemeier’s).

  2. 02 Technique

    Rectopexy technique and mesh detail

    Whether ventral, resection or suture rectopexy; whether mesh was used, of what type (biological or synthetic), and how it was fixed. For perineal cases, resection length and the type of anastomosis.

  3. 03 Findings

    Pelvic floor findings and adjuncts

    What was seen at surgery - associated intussusception, enterocele, sigmoidocele - and whether any concurrent gynaecological or pelvic floor issues were addressed.

  4. 04 Impression

    Follow-up, physiotherapy and mesh surveillance

    Read this first: the pelvic floor physio plan, laxative regime, follow-up intervals, and - if mesh was used - the long-term surveillance schedule.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Rectal prolapse surgery is usually covered when medically indicated.

Frequently asked

Everything we get asked about rectal prolapse surgery.

Quick answers on approach, mesh, continence, cost and NHS comparison.

  • What is the difference between rectal prolapse and haemorrhoids?

    Rectal prolapse is the full thickness of the rectum sliding through the anus - you see concentric circular folds. Haemorrhoids are swollen vascular cushions inside the anal canal that can protrude, but they are usually radial folds and mucosa only. The two are treated very differently - a rectopexy is the right operation for a prolapse, not for haemorrhoids.

  • Abdominal or perineal repair - which is right for me?

    It depends on fitness, age, prolapse size, bowel function and previous surgery. Younger, fitter patients usually do best with a laparoscopic or robotic ventral mesh rectopexy - the lowest recurrence rate. Frailer or comorbid patients often do better with a perineal operation such as Delorme’s or Altemeier’s - shorter operations, faster recovery, but higher recurrence. It is a joint decision with your surgeon after assessment.

  • Is mesh safe for rectopexy in the UK after the Cumberlege review?

    The Cumberlege review paused vaginal mesh for pelvic organ prolapse. Ventral mesh rectopexy uses abdominal (transabdominal) mesh through a different approach - the safety profile is very different and it is still offered in the UK. That said, no mesh is used casually: consent, choice, and long-term follow-up have all tightened, and mesh-free options (suture rectopexy, resection rectopexy) are available and discussed as standard.

  • Will my continence improve after surgery?

    For most patients, yes - the sphincter has been stretched by the prolapse and often recovers once the prolapse is repaired. But improvement is not guaranteed, and pelvic floor physiotherapy afterwards is important. If continence remains poor, biofeedback, sacral neuromodulation and other options can be considered later.

  • How much does private rectal prolapse surgery cost in the UK?

    Roughly £9,000–£14,000 for laparoscopic ventral mesh rectopexy, £12,000–£16,000 robotic, £10,000–£15,000 for resection rectopexy, and £8,000–£13,000 for perineal Delorme’s or Altemeier’s. Prices vary by hospital, surgeon and complexity.

  • How does this compare to the NHS pathway?

    NHS pelvic-floor units offer the same range of procedures with the same techniques. Private care buys shorter waits, choice of consultant, and single rooms - not a different operation. For urgent, symptomatic prolapse the NHS pathway is well established; for elective repair, many patients choose private care to shorten the wait and choose a named surgeon with declared subspecialty interest.

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