Our Summary

This study examined the outcomes and complications of surgeries for rectal prolapse (when the rectum slips out of place) and pelvic organ prolapse (when pelvic organs like the bladder drop because of weakness in the muscles supporting them) at a single hospital. The researchers looked at cases from 2008 to 2019 where both surgeries were done together.

They found that about 18% of patients had complications within 30 days of the surgery. The severity of these complications was categorized using the Clavien-Dindo classification system.

The study also found that patients who had their surgery done through the abdomen had fewer complications if the procedure was minimally invasive (using small incisions and special tools), compared to those who had a laparotomy (a larger incision through the abdominal wall).

In terms of the need for additional surgeries, 14% of patients needed another rectal prolapse surgery and about 5% needed another pelvic organ prolapse surgery. However, this difference was not statistically significant, meaning it could have happened by chance.

So overall, this study suggests that having both surgeries done together is associated with a reasonable risk of complications, and that a minimally invasive approach may be better for abdominal surgeries. More patients needed another rectal prolapse surgery compared to a pelvic organ prolapse surgery, but this difference wasn’t statistically significant.

FAQs

  1. What was the percentage of patients that had complications after the combined rectal and pelvic organ prolapse surgeries?
  2. What is the significance of the Clavien-Dindo classification system in this study?
  3. Does the study suggest that a minimally invasive procedure is better for abdominal surgeries?

Doctor’s Tip

A helpful tip a doctor might give a patient about rectal prolapse surgery is to discuss with them the potential risks and benefits of having both rectal prolapse and pelvic organ prolapse surgeries done together. It is important to consider the type of surgical approach, such as minimally invasive techniques, to potentially reduce the risk of complications. Additionally, patients should be aware that there is a possibility of needing additional surgeries in the future, particularly for rectal prolapse. It is important to have open communication with your healthcare provider and ask any questions you may have before undergoing surgery.

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. Patients with severe symptoms such as fecal incontinence, chronic constipation, and significant discomfort or pain are also candidates for surgery. Additionally, patients with recurrent or large rectal prolapse, or those who have associated pelvic organ prolapse, may be recommended for surgery to correct the issue.

Timeline

In summary, before rectal prolapse surgery, a patient may experience symptoms such as rectal bleeding, pain, and a feeling of a bulge or pressure in the rectum. They may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis.

After the surgery, patients may experience pain, swelling, and discomfort in the area of the surgery. They will be closely monitored for any signs of complications such as infection, bleeding, or bowel obstruction. Patients will also have follow-up appointments with their surgeon to ensure proper healing and to address any concerns or issues that may arise.

Overall, the goal of rectal prolapse surgery is to improve the patient’s quality of life by alleviating symptoms and preventing further prolapse of the rectum. With proper care and follow-up, most patients can expect a successful recovery and improved outcomes after surgery.

What to Ask Your Doctor

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

  • What are the potential risks and complications associated with this surgery?
  • What is the expected recovery time and what can I do to help facilitate a smooth recovery?
  • Are there any alternative treatment options available for rectal prolapse?
  • How many of these surgeries have you performed and what is your success rate?
  • Will I need to make any lifestyle changes or follow a special diet after the surgery?
  • What should I expect in terms of pain management following the surgery?
  • How long will I need to stay in the hospital after the surgery?
  • Will I need to have any follow-up appointments or tests after the surgery?
  • What is the likelihood of needing additional surgeries in the future after this procedure?
  • Are there any long-term risks or complications associated with rectal prolapse surgery?

Reference

Authors: Wallace SL, Syan R, Enemchukwu EA, Mishra K, Sokol ER, Gurland B. Journal: Int Urogynecol J. 2020 Oct;31(10):2101-2108. doi: 10.1007/s00192-020-04394-2. Epub 2020 Jun 23. PMID: 32577789