Our Summary

This research paper is about a rare condition known as external rectal prolapse, which is more prevalent in older women with multiple health issues. The paper describes five different surgical methods used to treat this condition, with a focus on a relatively new technique called perineal stapled prolapse resection (PSP).

In the PSP procedure, the prolapsed rectum (the part that has slipped out of its normal place) is completely turned out, cut into two halves, and then gradually removed with a special cutting tool.

The authors note that there isn’t a lot of evidence or research available on the treatment of external rectal prolapse. For the PSP method, only a few case studies exist showing similar results to other techniques, but there aren’t many studies comparing different methods.

The authors conclude that the PSP method is safe and effective, but because of the lack of research, it should be used primarily for older patients or those with multiple health conditions.

FAQs

  1. What is external rectal prolapse and who is most likely to be affected by it?
  2. What is the perineal stapled prolapse resection (PSP) procedure and how is it performed?
  3. What is the available research on the effectiveness of the PSP method compared to other surgical methods for treating external rectal prolapse?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow post-operative care instructions closely to ensure proper healing and reduce the risk of complications. This may include taking prescribed medications, maintaining proper hygiene, avoiding strenuous activities, and attending follow-up appointments with the surgeon. It is also important to communicate any concerns or changes in symptoms to the medical team for prompt evaluation and management.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried other non-surgical treatment options without success, have severe symptoms such as fecal incontinence or chronic constipation, and have a significant prolapse that is causing discomfort or interfering with their daily activities. Older patients, particularly women, with multiple health issues may be more likely to be recommended for surgery due to the increased risk of complications associated with their condition.

Timeline

Before rectal prolapse surgery:

  1. Patient experiences symptoms of rectal prolapse, such as feeling a bulge or mass protruding from the rectum, difficulty with bowel movements, and incontinence.
  2. Patient undergoes diagnostic tests, such as a physical exam, colonoscopy, or imaging studies, to confirm the diagnosis of rectal prolapse.
  3. Patient may undergo conservative treatments, such as pelvic floor exercises, dietary changes, or medications, to manage symptoms before considering surgery.

After rectal prolapse surgery:

  1. Patient undergoes preoperative preparation, including fasting, bowel preparation, and possibly antibiotics, before the surgery.
  2. Patient undergoes the rectal prolapse surgery, which may involve a variety of techniques such as perineal stapled prolapse resection (PSP), laparoscopic surgery, or traditional open surgery.
  3. Patient is monitored closely in the postoperative period for complications such as infection, bleeding, or bowel obstruction.
  4. Patient may experience pain, discomfort, and changes in bowel habits in the immediate postoperative period.
  5. Patient undergoes follow-up appointments with their surgeon to monitor their recovery and ensure the success of the surgery in correcting the rectal prolapse.

What to Ask Your Doctor

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

  1. What are the risks and potential complications associated with rectal prolapse surgery, specifically the perineal stapled prolapse resection (PSP) method?
  2. How experienced are you in performing rectal prolapse surgeries, and specifically the PSP technique?
  3. What is the success rate of the PSP procedure compared to other surgical methods for treating rectal prolapse?
  4. What is the recovery process like after rectal prolapse surgery, and how long can I expect to be in the hospital?
  5. Are there any long-term effects or considerations I should be aware of after undergoing rectal prolapse surgery?
  6. Are there any alternative treatments or non-surgical options for treating rectal prolapse that I should consider?
  7. Will I need to make any lifestyle changes or modifications to prevent the recurrence of rectal prolapse after surgery?
  8. How soon after surgery can I expect to return to normal activities, including work and exercise?
  9. Will I need any additional follow-up appointments or treatments after rectal prolapse surgery?
  10. Can you provide me with any additional resources or information about rectal prolapse surgery and the PSP technique?

Reference

Authors: Scherer R. Journal: Chirurg. 2016 Nov;87(11):933-937. doi: 10.1007/s00104-016-0290-2. PMID: 27678400