Our Summary

In simple terms, this paper discusses the current state of treatment for rectal prolapse in China, which is a condition where the rectum, the lower end of the bowel, slips out of place. Surgery is the only known cure for this ailment, but the type of surgery used and how doctors decide which one to use are still subjects of debate.

Two types of surgery, transabdominal (through the abdomen) and transperineal (through the anus), have been widely accepted as effective. However, it’s important to assess each case of rectal prolapse accurately before surgery to reduce the chances of the problem returning and to avoid complications related to the surgery.

The paper notes that the current system for assessing rectal prolapse needs to be improved and that the decision-making process for choosing a surgical method is controversial. To address these issues, a team of experts in colorectal and pelvic floor surgery from across China has come together to establish a standard approach to diagnosing and treating rectal prolapse.

They’ve created the “Chinese expert consensus on the diagnosis and surgical treatment of rectal prolapse (2022)”, which they hope will be a valuable resource for surgeons and will improve the way rectal prolapse is diagnosed and treated in China.

FAQs

  1. What are the two types of surgery commonly used for treating rectal prolapse?
  2. Why is it important to accurately assess each case of rectal prolapse before surgery?
  3. What is the “Chinese expert consensus on the diagnosis and surgical treatment of rectal prolapse (2022)” and why was it created?

Doctor’s Tip

A doctor might tell a patient undergoing rectal prolapse surgery to follow their post-operative care instructions carefully, including taking prescribed medications, eating a healthy diet high in fiber, avoiding heavy lifting, and attending follow-up appointments. It’s important for the patient to communicate any concerns or changes in symptoms to their doctor promptly to ensure a successful recovery.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as pelvic floor exercises, dietary changes, and medications without success. Individuals with severe symptoms such as chronic constipation, fecal incontinence, and discomfort or pain caused by the prolapse are also candidates for surgery.

Additionally, patients with full-thickness rectal prolapse, where the entire rectal wall protrudes through the anus, are more likely to require surgery compared to those with mucosal prolapse, where only the inner lining of the rectum protrudes.

Ultimately, the decision to undergo rectal prolapse surgery is made on a case-by-case basis, taking into consideration the patient’s overall health, age, symptoms, and the extent of the prolapse. It is important for patients to discuss their options with a colorectal surgeon to determine the most appropriate treatment plan for their individual situation.

Timeline

Before surgery, a patient may experience symptoms such as the feeling of a lump or mass protruding from the anus, pain during bowel movements, difficulty controlling bowel movements, and incontinence. They may also undergo various tests, such as a physical examination, colonoscopy, and imaging studies, to confirm the diagnosis of rectal prolapse.

After surgery, the patient will typically need to stay in the hospital for a few days for monitoring and pain management. They will be advised to avoid heavy lifting and strenuous activities for several weeks to allow the surgical site to heal properly. The patient may also need to follow a special diet to prevent constipation and promote healing.

In the months following surgery, the patient will have follow-up appointments with their surgeon to monitor their recovery and address any concerns or complications that may arise. With proper care and adherence to post-operative instructions, most patients can expect a successful outcome and improvement in their symptoms after rectal prolapse surgery.

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 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. How successful is rectal prolapse surgery in terms of long-term outcomes?
  5. What type of surgery do you recommend for my specific case of rectal prolapse, and why?
  6. Are there any alternative treatments or non-surgical options that I should consider?
  7. How experienced are you in performing rectal prolapse surgery, and what is your success rate?
  8. What can I do to prepare for surgery, both physically and mentally?
  9. Will I need to follow up with you regularly after surgery, and what signs or symptoms should I watch out for that may indicate a complication?
  10. Are there any factors that may increase the likelihood of the rectal prolapse returning after surgery, and how can I prevent this from happening?

Reference

Authors: Anorectal Branch of Chinese Medical Doctor Association; Pelvic Floor Surgery Committee, Anorectal Branch of Chinese Medical Doctor Association; Clinical Guidelines Committee, Anorectal Branch of Chinese Medical Doctor Association. Journal: Zhonghua Wei Chang Wai Ke Za Zhi. 2022 Dec 25;25(12):1081-1088. doi: 10.3760/cma.j.cn441530-20220425-00179. PMID: 36562231