Our Summary

This research paper analyzed the effectiveness and quality of life after two different types of rectal prolapse surgeries: the Delorme procedure and the Altemeier procedure. Rectal prolapse is a condition where the rectum (the last part of the large intestine) slips outside the anus.

The study included 75 patients, mostly women, who had either of the two surgeries between 2005 and 2013. The researchers found that patients who underwent the Altemeier procedure had a slightly longer hospital stay compared to those who had the Delorme procedure. The rate of the prolapse happening again was similar between the two procedures. However, the Altemeier procedure had a higher rate of post-surgery complications.

Overall, the researchers found that the Delorme procedure was a better option for patients who couldn’t have an abdominal repair of the rectal prolapse. This procedure had a lower risk of complications and was effective in controlling the prolapse in the short-term. Moreover, if the prolapse happened again, patients could have the same procedure without risking the blood supply to the rectum. The quality of life after either surgery was relatively the same according to the Cleveland Global Quality of Life scores.

FAQs

  1. What is the difference between the Delorme procedure and the Altemeier procedure for rectal prolapse surgery?
  2. Which procedure between the Delorme and the Altemeier has a higher rate of post-surgery complications?
  3. Is there a difference in the quality of life after undergoing either the Delorme or the Altemeier procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to discuss the potential risks and benefits of each procedure with their surgeon. It is important to understand the differences between the Delorme and Altemeier procedures, as well as the potential for post-surgery complications. Patients should also be aware of the likelihood of the prolapse happening again and the impact on their quality of life. Ultimately, the decision on which surgery to undergo should be based on individual needs and preferences, in consultation with a healthcare provider.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried non-surgical treatments such as pelvic floor exercises and dietary changes but have not seen improvement in their symptoms. Generally, patients with severe symptoms such as chronic constipation, fecal incontinence, and a protruding mass from the anus are candidates for surgery. Additionally, patients who have a history of multiple episodes of rectal prolapse or those who have associated conditions such as pelvic floor dysfunction, nerve damage, or connective tissue disorders may also be recommended for surgery. Ultimately, the decision to undergo rectal prolapse surgery is based on the individual patient’s symptoms, medical history, and overall health.

Timeline

Before rectal prolapse surgery:

  1. Patient experiences symptoms of rectal prolapse such as feeling a bulge or protrusion from the anus, difficulty controlling bowel movements, and pain or discomfort during bowel movements.
  2. Patient undergoes a physical examination and possibly diagnostic tests such as a colonoscopy or MRI to confirm the diagnosis of rectal prolapse.
  3. Patient discusses treatment options with their healthcare provider, including the possibility of surgery.
  4. Patient undergoes pre-operative preparations such as fasting before surgery, stopping certain medications, and following any instructions given by their healthcare provider.

After rectal prolapse surgery:

  1. Patient undergoes the chosen surgical procedure (Delorme or Altemeier) to repair the rectal prolapse.
  2. Patient may experience pain, discomfort, and swelling in the surgical area post-surgery.
  3. Patient is monitored in the hospital for a certain period of time depending on the type of surgery and any potential complications.
  4. Patient is discharged from the hospital and provided with post-operative care instructions, including wound care, pain management, and dietary restrictions.
  5. Patient follows up with their healthcare provider for post-operative check-ups to monitor healing and address any concerns.
  6. Patient may undergo physical therapy or pelvic floor exercises to improve bowel function and prevent future rectal prolapse episodes.
  7. Patient’s quality of life is assessed through follow-up appointments and quality of life surveys to evaluate the effectiveness of the surgery in controlling the rectal prolapse and improving overall well-being.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery?

  2. How long is the recovery process after the surgery and what can I expect in terms of pain and discomfort?

  3. Will I need to make any lifestyle changes or follow a special diet after the surgery?

  4. What is the success rate of the Delorme procedure versus the Altemeier procedure in preventing the prolapse from happening again?

  5. How long will I need to stay in the hospital after the surgery and when can I return to normal activities?

  6. Are there any long-term effects or complications that I should be aware of after the surgery?

  7. Will I need to follow up with a specialist or have any additional treatments after the surgery?

  8. How will the surgery affect my quality of life and daily activities in the long term?

  9. Are there any alternative treatment options to consider before undergoing surgery for rectal prolapse?

  10. Can you provide me with information about your experience and success rates with rectal prolapse surgeries, specifically the Delorme and Altemeier procedures?

Reference

Authors: Elagili F, Gurland B, Liu X, Church J, Ozuner G. Journal: Tech Coloproctol. 2015 Sep;19(9):521-5. doi: 10.1007/s10151-015-1337-y. Epub 2015 Jul 17. PMID: 26341686