Our Summary

This paper is a study on treatments for a condition called recurrent rectal prolapse (RRP), which is when part of the rectum slips out of place and comes out of the anus, and then keeps happening repeatedly. This problem doesn’t have an agreed-upon international treatment method, but it’s generally recommended that weaker, older patients get certain types of surgeries (Delormes or Thierschs), while stronger patients get surgeries that involve the abdomen.

The researchers looked at 22 patients (20 women and 2 men, aged from 37 to 92 years old) who had received different types of treatments for RRP over the past 20 years. The treatments included different types of surgeries, like abdominal mesh rectopexy, perineal sigmorectal resection, Delormes technique, Thierschs anal banding, colpoperineoplasty, and anterior sigmorectal resection. After the initial treatment, some patients had the prolapse happen again between 2 to 30 months later. In these cases, they had additional surgeries.

The results showed that half of the patients were completely cured. Six patients had RRP happen again, but they were successfully treated with additional surgeries. The researchers concluded that abdominal mesh rectopexy is the most effective treatment for RRP, and that total pelvic floor repair could prevent RRP. They also found that perineal rectosigmoid resection had less permanent effects for repairing RRP.

FAQs

  1. What are the different surgical treatment options for recurrent rectal prolapse (RRP)?
  2. What is the most effective method for treating RRP according to the study?
  3. What is the success rate of reoperations for RRP based on the study’s results?

Doctor’s Tip

A doctor may advise a patient undergoing rectal prolapse surgery to follow post-operative care instructions carefully, including proper wound care and avoiding heavy lifting or strenuous activities. They may also recommend maintaining a healthy diet high in fiber to prevent constipation, which can worsen rectal prolapse. It is important to attend follow-up appointments to monitor healing and address any concerns promptly.

Suitable For

Rectal prolapse surgery is typically recommended for patients who have recurrent rectal prolapse (RRP) and have not responded to conservative treatments. In this study, the surgical treatments for RRP included abdominal mesh rectopexy, perineal sigmorectal resection, Delormes technique, Thierschs anal banding, colpoperineoplasty, and anterior sigmorectal resection. The study found that abdominal mesh rectopexy was the most effective method for treating RRP, with a success rate of 50% in completely curing patients. Reoperations were also successful in treating subsequent RRP cases. It is important to note that the choice of surgical technique may depend on the age and overall health of the patient, with transabdominal surgeries typically being recommended for fitter patients.

Timeline

  • Initial treatment for rectal prolapse may consist of abdominal mesh rectopexy, perineal sigmorectal resection, Delormes technique, Thierschs anal banding, colpoperineoplasty, or anterior sigmorectal resection.

  • Relapses may occur between 2 to 30 months after initial treatment.

  • Reoperations may involve abdominal rectopexy with or without resection, perineal sigmorectal resection, Delormes technique, total pelvic floor repair, or perineoplasty.

  • Approximately 50% of patients may be completely cured after reoperations.

  • Some patients may develop subsequent recurrent rectal prolapse, requiring further reoperation.

  • Abdominal mesh rectopexy is considered the most effective method for treating rectal prolapse and recurrent rectal prolapse.

  • Total pelvic floor repair may help prevent future occurrences of recurrent rectal prolapse.

  • Perineal rectosigmoid resection may result in less permanent effects of recurrent rectal prolapse repair.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery?
  2. How long is the recovery period after surgery and what can I expect during this time?
  3. Will I need to make any lifestyle changes or follow a specific diet after surgery?
  4. Are there any alternative treatments or procedures available for rectal prolapse?
  5. What is the success rate of the specific surgical procedure you are recommending for me?
  6. How many times have you performed this surgery and what is your experience with treating rectal prolapse?
  7. Will I need to undergo any additional tests or preparations before the surgery?
  8. How long will the effects of the surgery last and is there a chance of recurrence in the future?
  9. What can I do to prevent future rectal prolapse after surgery?
  10. Are there any long-term effects or complications I should be aware of after the surgery?

Reference

Authors: Kościński T, Szmyt K. Journal: Pol Przegl Chir. 2023 Feb 17;95(4):1-5. doi: 10.5604/01.3001.0016.2727. PMID: 36808049