Our Summary

This research paper looks at the results of surgeries done on men who have complete rectal prolapse, a condition where the rectum, the last part of the large intestine, slips outside the anus. The researchers looked at studies published from 2000 to 2024 where more than 90% of the patients were men.

They found eight studies that included 452 patients, with an average age of 45.6 years. Most of the patients (80.5%) had abdominal surgeries, while 19.5% had procedures done around the anus.

The researchers found that the rate of the rectal prolapse coming back after surgery was lowest in those who had a specific type of abdominal surgery, called posterior mesh rectopexy (0.8%), followed by another abdominal surgery, resection rectopexy (0%), and highest in those who had surgery around the anus (19.3%).

The rate of complications was highest in those who had resection rectopexy (43.3%), and lowest in those who had another type of abdominal surgery, ventral mesh rectopexy (13.9%).

When it came to improving symptoms of constipation and inability to control bowel movements, the best results were seen in those who had resection rectopexy and posterior mesh rectopexy, respectively.

Overall, the researchers concluded that abdominal surgeries had longer operation times, but lower rates of the prolapse coming back and similar complication rates compared to surgeries around the anus.

FAQs

  1. What is the recurrence rate of rectal prolapse after different types of surgeries?
  2. Which type of surgery for rectal prolapse has the highest complication rates?
  3. Do abdominal surgeries for rectal prolapse have better outcomes compared to surgeries around the anus?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to discuss with their surgeon the different types of surgeries available, including abdominal surgeries like posterior mesh rectopexy and resection rectopexy, which have been shown to have lower rates of the prolapse coming back and fewer complications compared to surgeries done around the anus. It is important for patients to weigh the benefits and risks of each type of surgery and choose the option that is best for their specific situation.

Suitable For

This research suggests that rectal prolapse surgery, particularly abdominal surgeries such as posterior mesh rectopexy and resection rectopexy, may be more effective in preventing the prolapse from recurring and improving symptoms in male patients. These surgeries may be recommended for patients who have complete rectal prolapse and are looking for long-term relief from their symptoms. It is important for patients to discuss their individual case with a healthcare provider to determine the best course of treatment for their specific situation.

Timeline

  • Before surgery: Patients may experience symptoms such as rectal bleeding, pain, discomfort, and the feeling of a bulge or protrusion outside the anus. They may also have difficulty controlling bowel movements and experience constipation.

  • Consultation with a healthcare provider: Patients will meet with a surgeon to discuss their symptoms, medical history, and treatment options. The surgeon will likely perform a physical examination and may order imaging tests to confirm the diagnosis of rectal prolapse.

  • Pre-operative preparation: Patients may need to undergo pre-operative tests, such as blood tests and a colonoscopy, to ensure they are healthy enough for surgery. They may also need to adjust their diet or medications before the procedure.

  • Surgery: The type of surgery performed will depend on the severity of the rectal prolapse and the patient’s overall health. Abdominal surgeries, such as posterior mesh rectopexy or resection rectopexy, are commonly performed for rectal prolapse.

  • Post-operative recovery: Patients will need to stay in the hospital for a few days after surgery to recover. They may experience pain, swelling, and discomfort in the surgical area. They will be given instructions on how to care for their incision, manage pain, and prevent complications.

  • Follow-up appointments: Patients will need to follow up with their surgeon for post-operative appointments to monitor their recovery and ensure the success of the surgery. They may need to make lifestyle changes, such as dietary modifications or pelvic floor exercises, to improve bowel function and prevent recurrence of rectal prolapse.

What to Ask Your Doctor

  1. What are the different surgical options available for rectal prolapse, and which one do you recommend for me?
  2. What are the success rates of the different surgical procedures for rectal prolapse?
  3. What are the potential risks and complications associated with rectal prolapse surgery?
  4. How long is the recovery period after rectal prolapse surgery, and what can I expect during this time?
  5. Will I need to make any lifestyle changes or follow a special diet after surgery?
  6. How likely is it that the rectal prolapse will come back after surgery, and what can be done to prevent this from happening?
  7. Will I need any additional treatments or follow-up appointments after the surgery?
  8. How experienced are you in performing rectal prolapse surgeries, and what is your success rate with this procedure?
  9. Are there any alternative treatment options or non-surgical approaches that I should consider before opting for surgery?
  10. What can I do to prepare for the surgery and ensure the best possible outcome?

Reference

Authors: Emile SH, Wignakumar A, Horesh N, Garoufalia Z, Strassmann V, Boutros M, Wexner SD. Journal: Tech Coloproctol. 2024 Nov 13;28(1):158. doi: 10.1007/s10151-024-03039-6. PMID: 39538028