Our Summary

This research paper discusses a medical condition called rectal prolapse, which involves the rectum descending or falling out of its normal place. This condition can cause uncomfortable symptoms like difficulty in passing stool, pelvic pain, and loss of control over bowel movements. While many different surgical procedures have been used to treat this condition, none has proven to be clearly superior. Recently, however, a new technique called ventral mesh rectopexy (VMR) has shown promise. Unlike older methods, VMR reduces the risk of constipation after surgery. It has gained popularity due to its acceptable recurrence rate, good results, and low risk of complications related to the mesh used in the procedure. The paper talks about the current status of VMR, which is now often performed using minimally invasive techniques like laparoscopy or robotics, and is increasingly being recommended as the preferred treatment for rectal prolapse.

FAQs

  1. What is rectal prolapse and what symptoms does it cause?
  2. What is ventral mesh rectopexy (VMR) and how does it differ from older methods of treating rectal prolapse?
  3. What are the advantages of using minimally invasive techniques like laparoscopy or robotics in VMR?

Doctor’s Tip

One helpful tip a doctor might give a patient about rectal prolapse surgery is to follow all post-operative care instructions carefully. This may include taking prescribed medications, avoiding heavy lifting or strenuous activities, and following a special diet to promote healing. It is important to attend all follow-up appointments with your doctor to monitor your progress and address any concerns or complications that may arise. Additionally, maintaining good bowel habits, such as staying hydrated and eating a high-fiber diet, can help prevent recurrence of rectal prolapse in the future.

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. They may be experiencing significant symptoms such as chronic constipation, fecal incontinence, rectal bleeding, or severe discomfort. Patients with a complete rectal prolapse, where the rectum protrudes outside the body, are also good candidates for surgery. Additionally, patients who have a high risk of complications from rectal prolapse, such as those with underlying medical conditions like pelvic floor dysfunction or neurological disorders, may benefit from surgical intervention. Ultimately, the decision to undergo rectal prolapse surgery is made on a case-by-case basis by the patient and their healthcare provider after a thorough evaluation of their symptoms and medical history.

Timeline

Before rectal prolapse surgery:

  1. Symptoms of rectal prolapse develop, such as difficulty passing stool, pelvic pain, and loss of bowel control.
  2. Patient undergoes a physical examination and possibly other tests to confirm the diagnosis of rectal prolapse.
  3. Treatment options are discussed with the patient, including conservative measures and surgical options.
  4. Patient and surgeon decide on the best course of treatment, which may involve surgery if conservative measures have not been successful.

After rectal prolapse surgery:

  1. Patient undergoes pre-operative preparations, such as fasting and medication adjustments.
  2. Surgery is performed, either through open surgery, laparoscopy, or robotics, depending on the specific technique chosen.
  3. Patient is monitored in the recovery room and then transferred to a hospital room for further observation.
  4. Patient may experience pain, discomfort, and changes in bowel movements immediately following surgery.
  5. Patient is instructed on post-operative care, including wound care, pain management, and activity restrictions.
  6. Follow-up appointments are scheduled to monitor healing and address any concerns or complications.
  7. Over time, patient should experience improvement in symptoms related to rectal prolapse and may be able to resume normal activities.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery, specifically ventral mesh rectopexy (VMR)?

  2. How long is the recovery period after VMR surgery, and what can I expect in terms of pain and discomfort during this time?

  3. Will I need to make any lifestyle changes or follow a specific diet after the surgery to help with my recovery and prevent future rectal prolapse?

  4. Are there any alternative treatments to VMR that I should consider, and what are the pros and cons of each option?

  5. How successful is VMR in treating rectal prolapse, and what is the likelihood of the condition recurring after surgery?

  6. Will I need to undergo any additional procedures or follow-up appointments after the surgery, and what is the long-term outlook for my condition?

  7. How experienced is the surgeon in performing VMR procedures, and what is their success rate with this surgery?

  8. Are there any specific factors in my medical history or current health status that may impact the success of the surgery or my recovery process?

  9. What type of anesthesia will be used during the surgery, and what are the potential side effects or risks associated with it?

  10. Can you provide me with information on the hospital or surgical facility where the procedure will take place, including their success rates with VMR surgeries and any accreditation or certifications they hold?

Reference

Authors: van Iersel JJ, Paulides TJ, Verheijen PM, Lumley JW, Broeders IA, Consten EC. Journal: World J Gastroenterol. 2016 Jun 7;22(21):4977-87. doi: 10.3748/wjg.v22.i21.4977. PMID: 27275090