Our Summary

This paper looks at the different surgical methods used to treat a condition called complete rectal prolapse, where the rectum, the last part of the large intestine, comes out of the anus. The researchers reviewed several studies and compared the results of different surgical treatments. They found that a method called posterior mesh rectopexy was the most effective, with the lowest rate of the condition returning. Other methods, particularly those involving surgery through the perineum (the area between the anus and the genitals), had higher rates of the condition returning. However, there was not a significant difference in terms of complications, operation time, and improvement in fecal incontinence (the inability to control bowel movements) between the different surgical methods.

FAQs

  1. What is complete rectal prolapse and how is it treated surgically?
  2. Which surgical method was found to be most effective in treating rectal prolapse and why?
  3. Was there a significant difference in complications, operation time, and improvement in fecal incontinence among the different surgical methods?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to discuss with their surgeon the option of posterior mesh rectopexy, as it has been found to be the most effective method with the lowest rate of the condition returning. It is important to have a thorough discussion with the surgeon about the various surgical options available and their potential outcomes to make an informed decision about the best treatment approach for the individual patient.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those with complete rectal prolapse, where the rectum protrudes from the anus. This condition can cause discomfort, pain, and difficulty with bowel movements. Patients who have tried conservative treatments such as diet modifications, pelvic floor exercises, and medications without success may be candidates for surgery. Additionally, patients who experience fecal incontinence or other complications related to rectal prolapse may also be recommended for surgery. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if surgery is the best course of action for their specific case.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as difficulty with bowel movements, feeling a mass coming out of the anus, rectal bleeding, and incontinence. They may undergo tests such as a physical examination, colonoscopy, and imaging studies to confirm the diagnosis of rectal prolapse.

After the surgery, the patient will typically stay in the hospital for a few days for monitoring and pain management. They may experience some discomfort, swelling, and difficulty with bowel movements initially. It is important for the patient to follow post-operative instructions provided by their healthcare team, such as taking pain medications, maintaining good hygiene, and avoiding strenuous activities.

Over the following weeks and months, the patient will gradually recover and should see improvement in their symptoms. They may need to follow a special diet, do pelvic floor exercises, and attend follow-up appointments to monitor their progress. With proper care and rehabilitation, most patients can expect to fully recover from rectal prolapse surgery and resume normal activities.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery?
  2. What is the success rate of the specific surgical method recommended for my case?
  3. How long is the recovery period after rectal prolapse surgery?
  4. Will I need to make any lifestyle changes or follow a special diet after surgery?
  5. What are the chances of the condition returning after surgery?
  6. How experienced are you in performing rectal prolapse surgery?
  7. Are there any alternative treatments or non-surgical options for rectal prolapse that I should consider?
  8. How will the surgery affect my bowel movements and fecal incontinence, if I have that issue?
  9. Will I need to follow up with a specialist or undergo additional procedures after the initial surgery?
  10. What should I expect in terms of pain management and post-operative care following rectal prolapse surgery?

Reference

Authors: Emile SH, Khan SM, Garoufalia Z, Silva-Alvarenga E, Gefen R, Horesh N, Freund MR, Wexner SD. Journal: Tech Coloproctol. 2023 Oct;27(10):787-797. doi: 10.1007/s10151-023-02813-2. Epub 2023 May 8. PMID: 37150800