Our Summary

This research paper looks into the effectiveness of a specific surgical technique in the treatment of rectal prolapse - a condition where the rectum, the last part of the large intestine, slips out of place and can stick out of the anus.

The study found that adding an extra step to the surgery, known as a “middle compartment suspension”, could improve the success of the treatment. This extra step involves closing an area called the “pouch of Douglas” in the pelvis.

The researchers analyzed data from a large database of patients who underwent this type of surgery, with and without the additional step. They found that those who had the extra step included in their surgery were less likely to have a recurrence of their prolapse in the short term.

However, the authors caution that their findings should be interpreted carefully and more research is needed to confirm these results. They suggest that future studies should include a clear definition of “middle compartment suspension”, use validated measurements of the associated pathology, and longer follow-up times.

FAQs

  1. What is the additional step in the rectal prolapse surgery being studied, and what is its purpose?
  2. Did the study find that adding the “middle compartment suspension” to the surgery improved patient outcomes?
  3. What further research do the authors suggest to confirm their findings about the effectiveness of the extra step in rectal prolapse surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to make sure to follow post-operative instructions carefully, including taking prescribed medications, eating a high-fiber diet, and avoiding heavy lifting or strenuous activities. It is also important to attend all follow-up appointments to monitor healing and address any concerns. Additionally, maintaining good overall pelvic floor health through exercises and lifestyle modifications can help prevent future issues with rectal prolapse.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as diet modifications, pelvic floor exercises, and medication without success. In general, candidates for surgery are those who have severe symptoms such as persistent rectal prolapse, difficulty with bowel movements, fecal incontinence, and discomfort or pain in the rectal area.

Additionally, patients who are in good overall health and are able to tolerate surgery are also considered suitable candidates for rectal prolapse surgery. It is important for patients to discuss their individual medical history and symptoms with their healthcare provider to determine if surgery is the appropriate treatment option for them.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as difficulty passing stool, a feeling of incomplete bowel movements, rectal bleeding, and a protrusion of tissue from the anus. They may also undergo various diagnostic tests such as a physical examination, colonoscopy, and imaging studies to confirm the diagnosis.

After rectal prolapse surgery, the patient will typically experience some pain and discomfort in the pelvic area, which can be managed with pain medication. They may also need to follow a special diet and avoid heavy lifting or strenuous activities for a period of time. The patient will have follow-up appointments with their surgeon to monitor their recovery and ensure that the prolapse does not recur.

Overall, rectal prolapse surgery can lead to improvements in symptoms and quality of life for patients, but it is important to follow the post-operative care instructions provided by the medical team to ensure a successful recovery.

What to Ask Your Doctor

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

  1. What are the potential risks and complications of the surgery?
  2. How long is the recovery period after the surgery?
  3. Will I need to make any lifestyle changes after the surgery?
  4. What is the success rate of this specific surgical technique in treating rectal prolapse?
  5. Will I need any additional procedures or treatments after the surgery?
  6. How long do the results of the surgery typically last?
  7. Are there any alternative treatment options for rectal prolapse?
  8. What is the experience of the surgical team performing the procedure?
  9. What should I expect during the recovery process?
  10. How often will I need follow-up appointments after the surgery?

Reference

Authors: Bordeianou L, Ogilvie J, Murphy M, Hyman N, Vogler S, Ky A, Oliveira L, Gurland B; Members of the Pelvic Floor Disorders Consortium Quality Improvement in Rectal Prolapse Surgery Database Pilot. Journal: Dis Colon Rectum. 2022 Dec 1;65(12):1522-1530. doi: 10.1097/DCR.0000000000002495. Epub 2022 Sep 8. PMID: 36102871