Our Summary

This study aimed to understand how different factors affect the recurrence of full-thickness rectal prolapse (FTRP), a condition where the rectum slips outside the anus, after surgery. Specifically, they looked at how much the rectum was moved during surgery, how the rectum was fixed back in place, and whether the surgery was done with traditional open methods or less invasive laparoscopic techniques.

They analyzed data from 532 patients, who were followed for a period ranging from 12 to 235 months after their surgeries. 8.6% of these patients experienced a recurrence of FTRP.

Four factors seemed to relate to recurrence: a history of incontinence (lack of control over bowel movements), constipation, how much the rectum was moved during surgery, and whether a part of the large intestine (sigmoid colon) was removed. However, when they analyzed these factors together, only the extent of rectum movement was significantly linked to recurrence.

In simpler terms, the study found that moving the rectum all the way around during surgery was associated with lower chances of FTRP coming back in the long term. The way the rectum was fixed back in place and the type of surgery (open or laparoscopic) did not seem to affect recurrence.

FAQs

  1. What factors can affect the recurrence of full-thickness rectal prolapse after surgery?
  2. Does the type of surgery (open or laparoscopic) affect the recurrence of full-thickness rectal prolapse?
  3. How does the extent of rectum movement during surgery influence the recurrence of full-thickness rectal prolapse?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about rectal prolapse surgery is to ensure that the rectum is moved as much as needed during the procedure to reduce the risk of recurrence. It is also important for patients to discuss their history of incontinence and constipation with their doctor to address any potential risk factors. Additionally, patients should follow their doctor’s post-operative instructions carefully to promote proper healing and reduce the likelihood of complications.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have full-thickness rectal prolapse and have not responded to conservative treatments such as dietary changes, pelvic floor exercises, and medications. Additionally, patients who have a history of incontinence, constipation, or significant rectal movement during surgery may be at higher risk for recurrence and may benefit from surgical intervention. It is important for patients to discuss their individual symptoms and medical history with their healthcare provider to determine if surgery is the best course of action for them.

Timeline

Before the rectal prolapse surgery, a patient may experience symptoms such as a feeling of a bulge or protrusion from the anus, difficulty controlling bowel movements, constipation, and discomfort or pain during bowel movements. They may also have undergone diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis of rectal prolapse.

After the surgery, the patient will typically stay in the hospital for a few days to recover. They may experience some pain and discomfort, which can be managed with pain medication. The patient will be advised to follow a specific diet to promote healing and prevent constipation. They will also be instructed on how to care for the surgical incision and when to follow up with their healthcare provider.

In the weeks and months following the surgery, the patient will gradually resume normal activities and may undergo physical therapy to strengthen the pelvic floor muscles. They will be monitored for any signs of recurrence, such as a return of symptoms or physical examination findings. Follow-up appointments with their healthcare provider will be scheduled to assess their progress and address any concerns.

Overall, rectal prolapse surgery can provide relief from symptoms and improve the quality of life for patients. With proper care and follow-up, the risk of recurrence can be minimized, allowing patients to return to their normal daily activities with confidence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery based on this study include:

  1. How much will my rectum be moved during the surgery?
  2. What technique will be used to fix my rectum back in place?
  3. Will a part of my sigmoid colon be removed during the surgery?
  4. How likely is it that I will experience a recurrence of rectal prolapse after the surgery?
  5. What steps can I take to reduce my risk of recurrence after surgery?
  6. How long is the recovery period after rectal prolapse surgery?
  7. Are there any potential risks or complications associated with this surgery?
  8. What are the success rates of open surgery versus laparoscopic surgery for rectal prolapse?
  9. Will I need to make any lifestyle changes or follow a specific diet after the surgery to prevent recurrence?
  10. How often will I need follow-up appointments after the surgery to monitor my progress?

Reference

Authors: Bishawi M, Foppa C, Tou S, Bergamaschi R; Rectal Prolapse Recurrence Study Group. Journal: Colorectal Dis. 2016 Aug;18(8):779-84. doi: 10.1111/codi.13160. PMID: 26476263