Our Summary

This research article analyzes different surgical methods used to treat external rectal prolapse (ERP), a condition where the rectum slips outside the body. The researchers looked at 24 studies comparing various surgical techniques and their effects on complications, quality of life, and recurrence of the condition. They found that both abdominal and perianal (around the anus) surgeries can effectively address the symptoms and improve the patient’s quality of life. Laparoscopy, a minimally invasive surgical method, showed better short-term outcomes. They also found that a technique called rectopexy, with or without resection (removal of part of the organ), offered a low risk of the condition recurring, with a complication rate similar to perianal surgery. However, they caution that the quality of most studies was poor and could be biased. They recommend that the choice of surgery should be personalized, taking into account the risks and potential benefits to the patient’s quality of life. They also suggest that laparoscopy and modern anesthesia have made abdominal surgeries more appealing, even for older patients.

FAQs

  1. What are the different surgical methods used to treat external rectal prolapse as mentioned in the study?
  2. According to the study, which surgical method showed better short-term outcomes and why?
  3. What factors should be taken into account when choosing a surgical method for treating rectal prolapse as recommended in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to carefully follow post-operative instructions provided by the medical team, including proper wound care, activity restrictions, and medication management. It is important to communicate any concerns or changes in symptoms to the doctor promptly to ensure a successful recovery. Additionally, maintaining a healthy diet and lifestyle can help prevent future complications and improve overall outcomes.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as dietary changes, pelvic floor exercises, and medications without success. Surgical intervention is usually recommended for patients with severe symptoms such as chronic pain, fecal incontinence, and difficulty with bowel movements. Additionally, patients who have recurrent rectal prolapse or those with underlying conditions that contribute to the prolapse may also be candidates for surgery. The choice of surgical technique will depend on factors such as the patient’s overall health, the extent of the prolapse, and the surgeon’s expertise.

Timeline

  1. Patient experiences symptoms of rectal prolapse, such as feeling a bulge or pressure in the rectum, difficulty controlling bowel movements, and discomfort or pain during bowel movements.
  2. Patient sees a doctor for evaluation and diagnosis of rectal prolapse, which may involve a physical examination, imaging tests, and possibly a colonoscopy.
  3. Doctor recommends surgical treatment for rectal prolapse after considering the severity of the condition, the patient’s overall health, and their preferences.
  4. Patient undergoes preoperative evaluations and tests to ensure they are fit for surgery, such as blood tests, imaging studies, and possibly a colonoscopy.
  5. Patient undergoes rectal prolapse surgery, which can be either abdominal or perianal, with options such as rectopexy with or without resection.
  6. After surgery, the patient will likely experience pain, discomfort, and possible complications such as infection, bleeding, or urinary issues.
  7. Patient will be monitored in the hospital for a few days post-surgery to ensure proper healing and management of any complications.
  8. Patient will be discharged from the hospital and will continue to recover at home, following the doctor’s instructions for wound care, pain management, and resuming normal activities.
  9. Patient will have follow-up appointments with the surgeon to monitor their recovery, address any concerns or complications, and assess the long-term success of the surgery in treating rectal prolapse.
  10. Patient will hopefully experience improved symptoms, quality of life, and bowel function after rectal prolapse surgery, with a low risk of the condition recurring.

What to Ask Your Doctor

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

  1. What are the different surgical options available for treating rectal prolapse?
  2. What are the potential risks and complications associated with each type of surgery?
  3. What is the success rate of the surgery in terms of symptom improvement and recurrence of the condition?
  4. How long is the recovery period after surgery and what can I expect in terms of pain and discomfort?
  5. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  6. Are there any long-term effects or complications that I should be aware of?
  7. How experienced are you in performing this type of surgery and what is your success rate?
  8. Are there any alternative treatments or non-surgical options that I should consider?
  9. How will the surgery impact my quality of life and daily activities?
  10. Are there any specific factors about my health or medical history that may affect the success of the surgery?

Reference

Authors: Murphy PB, Wanis K, Schlachta CM, Alkhamesi NA. Journal: Minerva Chir. 2017 Feb;72(1):71-80. doi: 10.23736/S0026-4733.16.07205-9. Epub 2016 Oct 6. PMID: 27711030