Our Summary

This research paper is about a case where a woman suffering from rectal prolapse - a condition where the inner layers of the rectum protrude outward through the anus - saw her condition improve after undergoing surgery to correct a vaginal defect.

The patient, a 53-year-old woman who had previously undergone a hysterectomy, came to the clinic complaining of a vaginal bulge, frequent urge to urinate, and rectal bulge when straining. However, she did not have any issue with fecal incontinence. An examination revealed that she had stage 2 anterior, posterior, and apical vaginal prolapse and reducible rectal prolapse.

The patient underwent surgery to correct the vaginal prolapse, which included repairing an enterocele (a hernia of the intestine) and a rectocele (a hernia of the rectum), using a mesh through an anterior vaginal approach, and other procedures.

Remarkably, after the surgery, the patient reported that both her vaginal and rectal prolapse had resolved. She continued to be free from rectal prolapse for more than a year after the surgery, which was confirmed by physical examination.

The researchers concluded that, while more research is needed, this case suggests that rectal prolapse caused by a pressure from the front of the rectum might not need an additional procedure if the vaginal prolapse and enterocele are repaired. This less invasive approach could be beneficial to patients.

FAQs

  1. What was the condition of the patient before undergoing the surgery?
  2. What procedures were done during the surgery to correct the patient’s vaginal prolapse?
  3. What were the findings and conclusions of the researchers based on this case?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about rectal prolapse surgery is to make sure to follow post-operative care instructions carefully, including avoiding heavy lifting and straining, eating a high-fiber diet to prevent constipation, and keeping the surgical area clean to prevent infection. It is also important to attend all follow-up appointments with your healthcare provider to ensure proper healing and address any concerns.

Suitable For

Patients who are typically recommended for rectal prolapse surgery are those who have significant symptoms such as a protruding rectal mass, fecal incontinence, difficulty with bowel movements, and discomfort or pain. Rectal prolapse surgery is considered when conservative treatments such as pelvic floor exercises, dietary changes, and medications have not been effective in managing the symptoms. Patients with severe or recurrent rectal prolapse, as well as those with associated conditions such as pelvic organ prolapse or enterocele, may also be candidates for surgery.

In the case discussed above, the patient’s rectal prolapse was related to a vaginal defect, and surgery to correct the vaginal prolapse resulted in resolution of the rectal prolapse. This suggests that in some cases, addressing the underlying cause of the prolapse may lead to improvement in rectal prolapse without the need for a separate rectal surgery.

Overall, the decision to recommend rectal prolapse surgery is based on the individual patient’s symptoms, overall health, and the underlying cause of the prolapse. It is important for patients to discuss their options with a healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

In summary, the timeline of the patient’s experience before and after rectal prolapse surgery is as follows:

  • Before surgery: The patient presented with symptoms of vaginal and rectal prolapse, including a bulge in the vagina, frequent urge to urinate, and rectal bulge when straining. She underwent examination, which revealed stage 2 anterior, posterior, and apical vaginal prolapse and reducible rectal prolapse.

  • Surgery: The patient underwent surgery to correct the vaginal prolapse, enterocele, and rectocele using a mesh through an anterior vaginal approach, along with other procedures.

  • After surgery: The patient reported that both her vaginal and rectal prolapse had resolved following the surgery. She continued to be free from rectal prolapse for more than a year after the surgery, as confirmed by physical examination.

Overall, the patient experienced improvement in her rectal prolapse after undergoing surgery to correct a vaginal defect, suggesting a less invasive approach may be beneficial for patients in similar cases.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery include:

  1. What are the potential risks and complications associated with rectal prolapse surgery?
  2. What are the expected outcomes and success rates of rectal prolapse surgery?
  3. Will I need to take any special precautions or follow a specific diet before or after the surgery?
  4. How long is the recovery period after rectal prolapse surgery and what can I expect during this time?
  5. Are there any alternative treatment options for rectal prolapse that I should consider?
  6. Will I need to undergo any additional procedures or surgeries in the future to address my rectal prolapse?
  7. How long will the effects of rectal prolapse surgery last and are there any long-term considerations I should be aware of?
  8. Will I need to make any lifestyle changes or modifications after rectal prolapse surgery to prevent recurrence?
  9. What type of follow-up care and monitoring will be necessary after rectal prolapse surgery?
  10. Can you provide me with more information about your experience and success rates with rectal prolapse surgery?

Reference

Authors: Devakumar H, Chandrasekaran N, Alas A, Martin L, Davila GW, Hurtado E. Journal: Female Pelvic Med Reconstr Surg. 2017 Jan/Feb;23(1):e4-e7. doi: 10.1097/SPV.0000000000000354. PMID: 27898453