What is Altemeier’s procedure?

Altemeier’s procedure is an operation performed through the back passage (anus) to repair an external rectal prolapse. This technique removes the prolapsing bowel and reattaches the remaining bowel internally.

There are other surgical options for treating rectal prolapse, and your surgeon will discuss the most suitable procedure for you.

What does the operation involve?

• Before surgery, you will need to take strong laxatives at home to clear your bowel. You will receive written instructions on when to take the laxatives and when to stop eating and drinking

• The procedure is performed under a general anaesthetic but can also be carried out under a spinal anaesthetic if necessary

• The prolapsing bowel is removed through the anus, and the remaining bowel is rejoined using sutures

• The operation typically takes around 60 minutes to complete

What are the risks?

Although Altemeier’s procedure is a relatively safe surgery, all operations carry some risks.

General surgical risks

• Blood clots (DVT/PE) – You will be given stockings and blood-thinning injections to reduce the risk

• Bleeding – Some patients may notice small amounts of blood when opening their bowels after surgery. This usually settles within the first week

• Infection – Rare, but if the bowel join becomes infected, antibiotics or further surgery may be needed

Bowel-related risks

• Anastomotic leak (separation of the bowel join) – This is very rare but may require antibiotics or another operation

• Bowel control – If you previously had bowel incontinence, this may improve after surgery. However, if symptoms persist, further tests such as anorectal physiology or endo-anal ultrasound may be required

What happens after the operation?

• Pain management – Most patients experience minimal pain after this procedure and require only simple oral painkillers within 24 hours

• IV fluids – A drip is usually in place for 24 hours

• Bladder care – If a catheter was used during surgery, it is normally removed the next day

• Eating and drinking – You can start eating and drinking as soon as you feel able, usually on the same day as surgery

• Bowel care – You will be given a stool softener for 4-6 weeks to prevent straining

Recovery at home

• Hospital stay is typically 3-5 days, though this may vary

• Avoid heavy lifting and strenuous activity for at least 6 weeks

• Driving can usually be resumed within 2 weeks, but this depends on your recovery

• A follow-up consultation will be arranged approximately two weeks after discharge, or sooner if needed

Why choose the Midlands Bowel Clinic?

• Expert colorectal surgeons – Our team has extensive experience in treating rectal prolapse with both perineal and abdominal procedures

• Minimally invasive techniques – Where appropriate, we use keyhole (laparoscopic) surgery for faster recovery

• Comprehensive care – We offer thorough pre-operative assessments and tailored post-operative support

• Personalised treatment plans – Every patient is assessed individually to determine the most suitable surgical approach

• State-of-the-art facilities – We provide advanced diagnostic and surgical treatments in a professional and comfortable setting

Contact us

If you have any questions about Altemeier’s procedure or would like to discuss your treatment options, please contact the Midlands Bowel Clinic. Our team is here to support you every step of the way.