Our Summary

This study looked at how treatments for rectal prolapse (when the rectum slips out of place) have changed over a period of 10 years. The researchers analyzed data from a national database in Denmark, which recorded all surgeries for rectal prolapse from 2004 to 2014.

They found that 1,625 patients underwent 1,834 operations during this period. Most of these patients were women, and the average age at the time of surgery was about 72 years old. The types of surgeries performed changed over the decade, with an increase in the number of operations and a growing preference for laparoscopic procedures, which are minimally invasive surgeries done through small incisions.

About 16% of patients needed to have a second surgery. The type of first surgery significantly influenced this rate - 26% of those who had a perineal procedure (a type of surgery performed through the perineum, the area between the anus and the genitals) needed a second operation, compared to only 10% of those who had open or laparoscopic rectopexy (a surgery that secures the rectum in its proper position).

The most common type of second surgery was laparoscopic rectopexy. The overall death rate within 30 days of surgery was 2.1%, and there wasn’t a significant difference in this rate between the different types of surgeries.

In simple terms, the study showed that more operations for rectal prolapse are being performed, and that laparoscopic rectopexy is becoming more popular. It also highlighted that patients who initially had a perineal procedure were more likely to need a repeat operation.

FAQs

  1. What is the most common type of surgery used for rectal prolapse?
  2. Is there a difference in the reoperation rates between different types of rectal prolapse surgeries?
  3. Has the overall number of rectal prolapse surgeries increased over the years?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow post-operative care instructions closely to promote healing and prevent complications. This may include taking prescribed medications, avoiding heavy lifting or strenuous activities, and maintaining good hygiene in the affected area. It is also important to attend follow-up appointments with your healthcare provider to monitor your recovery progress and address any concerns.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have not responded to conservative treatments such as dietary changes, pelvic floor exercises, and medication. Surgery is often recommended for patients with significant symptoms such as chronic constipation, fecal incontinence, and the protrusion of rectal tissue through the anus. Additionally, patients who are in good overall health and able to undergo surgery are candidates for rectal prolapse surgery. The choice of primary operation, whether it be perineal procedures or laparoscopic rectopexy, may impact the likelihood of reoperation, with laparoscopic procedures showing lower reoperation rates in some studies.

Timeline

Before rectal prolapse surgery:

  • Patient may experience symptoms such as rectal bleeding, pain, and the sensation of a mass protruding from the rectum.
  • Patient may undergo diagnostic tests such as a physical examination, colonoscopy, and imaging studies to confirm the diagnosis of rectal prolapse.
  • Patient may undergo conservative treatments such as pelvic floor exercises, dietary changes, and medications to manage symptoms.

After rectal prolapse surgery:

  • Patient undergoes the surgical procedure, which may be performed through open or laparoscopic techniques.
  • Patient may experience a recovery period in the hospital or at home, with pain management and follow-up appointments with the surgeon.
  • Patient may need to make lifestyle changes such as avoiding heavy lifting and straining during bowel movements to prevent recurrence of rectal prolapse.
  • Patient may undergo reoperation if the initial surgery is not successful, with laparoscopic rectopexy being the most common reoperation procedure.
  • The overall reoperation rate for rectal prolapse surgery is 16%, with a higher rate for perineal procedures compared to laparoscopic rectopexy.

What to Ask Your Doctor

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

  1. What are the different types of surgeries available for treating rectal prolapse?
  2. What are the potential risks and complications associated with rectal prolapse surgery?
  3. How long is the recovery process and what can I expect during the recovery period?
  4. What is the success rate of the surgery in terms of resolving the rectal prolapse?
  5. Are there any alternative treatments or non-surgical options for rectal prolapse?
  6. How many of these surgeries have you performed and what is your experience with this procedure?
  7. What can I do to prepare for the surgery and what should I expect before, during, and after the procedure?
  8. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  9. What symptoms should I watch out for after the surgery and when should I contact you for follow-up care?
  10. Are there any long-term effects or considerations I should be aware of after having rectal prolapse surgery?

Reference

Authors: Bjerke T, Mynster T. Journal: Int J Colorectal Dis. 2018 Mar;33(3):299-304. doi: 10.1007/s00384-017-2944-z. Epub 2017 Dec 23. PMID: 29273884