Our Summary

A 61-year-old woman who had undergone a complex surgery for rectal cancer developed a condition known as neorectal prolapse, where the rectum slips so it protrudes from the anus. This caused her pain and bleeding. The issue was successfully treated with a surgical procedure called a perineal stapled prolapse resection, which involves removing the part of the rectum that’s causing the problem and then using a special stapling device to reattach the rectum.

FAQs

  1. What types of complications did the 61-year-old woman experience after her initial rectal cancer surgery?
  2. How was the neorectal prolapse in the patient treated?
  3. What were the results and outcomes of the perineal stapled prolapse resection?

Doctor’s Tip

A doctor may advise the patient that after rectal prolapse surgery, it is important to follow post-operative care instructions carefully, including keeping the area clean and avoiding heavy lifting or straining. It is also important to attend follow-up appointments to monitor healing and address any concerns. Additionally, maintaining a high-fiber diet and staying hydrated can help prevent constipation and further straining on the rectum.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have a significant rectal prolapse that causes symptoms such as anal pain, bleeding, and difficulty with bowel movements. In this case, the patient had a 3 cm full thickness reducible prolapse that was causing discomfort and bleeding. Surgery may be recommended for patients who have tried conservative treatments such as pelvic floor exercises and dietary modifications without success. Additionally, patients who have a history of rectal cancer surgery, as in this case, may also be candidates for rectal prolapse surgery to address the prolapse that developed as a complication of the previous surgery.

Timeline

Before surgery:

  • Patient presents with symptoms such as anal pain, bleeding, and a visible rectal prolapse
  • Patient undergoes evaluation and diagnosis of rectal prolapse, including physical examination and possibly imaging tests
  • Treatment options are discussed, including non-surgical and surgical options
  • Patient and healthcare team decide on surgical intervention as the best course of action

After surgery:

  • Patient undergoes perineal stapled prolapse resection surgery to address the rectal prolapse
  • Post-operative recovery period, which may include pain management, monitoring for complications, and gradual return to normal activities
  • Follow-up appointments with healthcare team to monitor healing and address any concerns
  • Patient experiences improvement in symptoms such as pain and bleeding, and hopefully a resolution of the rectal prolapse
  • Long-term follow-up to monitor for recurrence and ensure the success of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications of rectal prolapse surgery?
  2. How long is the recovery period after rectal prolapse surgery?
  3. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  4. How successful is rectal prolapse surgery in treating the condition long-term?
  5. Are there any alternative treatments or procedures available for rectal prolapse?
  6. Will I need to undergo any additional tests or procedures before the surgery?
  7. What type of anesthesia will be used during the surgery?
  8. How experienced are you in performing rectal prolapse surgery?
  9. How many of these surgeries have you performed, and what is your success rate?
  10. What can I expect in terms of pain management after the surgery?

Reference

Authors: Baltazar JPA, Lopez MPJ, Onglao MAS. Journal: BMJ Case Rep. 2022 Jan 4;15(1):e246356. doi: 10.1136/bcr-2021-246356. PMID: 34983809