Skip to main contentLast updated: 04-Nov-2026

Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
GI & Proctology Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
Most people do well after prolapse surgery. Three things need watching later. Does the prolapse come back? Is any mesh behaving? Does your bowel work better than before?
A returning lump, discharge, bleeding or new pain should be examined, not settled by phone. Early review often means a small fix instead of a big operation.
No operation removes the chance of return for good. A written follow-up plan, and an open door to come back sooner, are part of the treatment.
The full picture of rectal prolapse and its treatment is on our rectal prolapse surgery page. This post covers the time after the operation: what can go wrong, and how we keep watch.
Most operations go smoothly, and serious problems are uncommon. They fall into a few groups, and each has a typical time and a typical sign.
| Problem | When it shows | What you may notice | What we do |
|---|---|---|---|
| Prolapse returns | Months to years | A lump or a bulge when you strain | Examine, repeat the scan, then plan |
| Leak at the join of the bowel | First days | Fever, belly pain, feeling very unwell | Scan, drainage, antibiotics, sometimes a temporary stoma |
| Wound trouble | Days to weeks | Discharge, redness, a wound that opens | Dressings and wound care |
| Mesh showing through | Months to years | Discharge, spotting, pain during sex | Examination, then remove the exposed part |
| Mesh infection | Weeks to years | Fever, pain, a sore that keeps draining | Antibiotics, often removal of the mesh |
| New or worse constipation | Weeks to months | Straining, a feeling of not emptying | Exercise training, laxatives, a transit study |
| Leaking that stays | Ongoing | Soiling or a rush you cannot hold | Exercises, medicine, then other options |
Most of these are found early if you come for the planned visits and tell us what you notice.
Yes, it can. The chance depends on the route used and on your health. A repair through the abdomen holds longer than a smaller repair through the perineum.
| First operation | Chance of return | Why |
|---|---|---|
| Repair through the perineum | Higher | Gentler on the body, but the rectum is not fixed to the bone |
| Rectopexy with stitches | Lower | The rectum is fixed up, but a stitch can pull loose |
| Rectopexy with a resection | Lower | Durable, but needs a join in the bowel |
| Ventral mesh rectopexy | Lowest | The rectum is held up by a strip of mesh |
A perineal repair is often the right choice for a frail person. A higher chance of return is the price of a smaller operation, and we agree this with you beforehand.
Not every lump means a return. It can be a piece of lining, a pile, or a bulge into the vagina, and each needs a different answer. We examine you and repeat the scan before deciding anything.
Mesh gives the lowest chance of return, with less constipation than older repairs. Its problems are uncommon, but they shape both the consent and the follow-up.
The mesh type is a real choice. Synthetic mesh is strong and lasts. Biological mesh wears through less often, but costs more and its long-term strength is less certain. For some people we choose no mesh at all. We explain this before surgery and note the mesh type in your papers.
If you are told mesh has been seen on a scan but you feel fine, nothing needs doing. We act on symptoms and signs, not on a picture alone.
An unhappy patient with a well-fixed rectum is common. Fixing the bowel does not fix a pelvic floor that fails to relax. Nor does it fix an anal muscle stretched for years.
| Trouble after surgery | Likely reason | What helps |
|---|---|---|
| Still cannot empty | A pelvic floor that tightens instead of relaxing | Biofeedback exercise training, not another operation |
| New constipation | Nerves bruised during the dissection, or a slow colon | Laxatives, exercise training, a transit study |
| Leaking that stays | A stretched anal muscle that recovers slowly | Exercises, medicine, bowel training, then nerve stimulation |
| Urgency after a smaller rectum | Less room to hold stool | Medicine and time, as it usually settles |
| Pain during sex | Mesh position, or wear of the mesh | Examination, then care with the gynae team |
Before any second operation, we test the pelvic floor again. Many “failed” operations were really a muscle problem that surgery could not fix.
Some signs mean wait and mention it at your next visit. Others mean call the same day. Knowing the difference saves worry and saves time.
Please do not wait for a planned visit if you are worried. Do not accept that discharge or bleeding after surgery is “just piles” without being examined. That mistake delays the diagnosis of mesh problems.
Follow-up is planned in writing, so you know what to expect. It is lighter after a perineal repair and more structured after a mesh repair.
| Visit | What we check |
|---|---|
| About six weeks | Wound, bowel habit, any lump, any leakage, how you feel |
| About six months, after a mesh repair | Examination, mesh position and comfort, bowel and bladder function, sexual comfort |
| Every year, after a mesh repair | The same review, and a record of your symptoms against your first scores |
| Any time you are worried | Open access. You do not need to wait for a booked date |
At each visit we compare your answers with the scores we noted before surgery. This tells us how much you truly improved, and not only how you remember it.
You leave with a written list of warning signs and a phone number. This matters more if you live far away, or if your local doctor has not seen mesh problems before.
A return is not a failure of you or of the surgeon. It is a known risk that we plan for. The next step depends on the first operation, your fitness today and a fresh scan.
A second operation is a harder operation than the first. Repair after a return is safer in a unit that does this often. We say so plainly.
Yes, it can. Repair through the perineum is more likely to return than repair through the abdomen. No operation removes the chance fully, which is why we plan check-ups.
Something comes down again when you strain, or emptying gets hard again. Not every lump is a return. It can be a piece of lining or a pile, so an examination comes before any decision.
Mesh is used in a well-chosen group and the problems are uncommon. They include mesh showing through the bowel or vagina, and infection. They are found early if you report discharge, bleeding or pain, and attend your visits.
Some people strained before surgery because the pelvic floor does not relax. Fixing the bowel does not fix that. Exercise training with a therapist often helps, and a new scan may be needed.
It improves in many people, but not all. A stretched anal muscle may recover slowly or only in part. Exercises, medicine and bowel training come first, and other options exist if these fail.
Call at once for fever with belly or back pain. Call for heavy bleeding, or a lump that will not go back and turns dark. Call if your belly swells and no stool or gas passes. Do not wait for your next visit.
The first review is at about six weeks. After a mesh repair we also see you at six months and then yearly. You can come sooner at any time if something changes.
For the whole range of prolapse care, start at the rectal prolapse surgery page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Had a prolapse operation and something does not feel right? A lump has returned, you are leaking, or you are not sure what is normal? Dr Harsh Shah will examine you, find out what is behind the problem and plan the next step. Call, or send a message on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
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