Our Summary

This research paper is about rectal prolapse, a condition where the rectum, the last part of the large intestine, slips outside the anus. This can significantly affect a person’s quality of life. It is more common in elderly women, affecting about 2.5 out of every 100,000 people. The aim of this paper is to provide a guide based on scientific evidence to help doctors manage and treat rectal prolapse in a way that is tailored to each patient’s needs.

The researchers found the information used in the paper by searching electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL and EMBASE. They used the American College of Gastroenterology’s Chronic Constipation Task Force’s criteria to define and grade their recommendations. They created five levels of evidence and graded the recommendations as A, B, or C. The paper discusses different treatments for rectal prolapse, including non-surgical management and surgical treatment through either an abdominal or perineal (the area between the anus and the genitals) approach.

FAQs

  1. What is rectal prolapse and how does it impact quality of life?
  2. What is the estimated incidence of rectal prolapse and who is most likely to experience it?
  3. What strategies are used to manage and treat complete 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 carefully, including avoiding heavy lifting and straining, eating a high-fiber diet to prevent constipation, and attending follow-up appointments to monitor healing and address any concerns. It is important to communicate openly with your healthcare provider about any symptoms or changes in your condition to ensure optimal recovery and long-term success of the surgery.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those with severe symptoms and significant impact on quality of life, such as:

  1. Elderly individuals, particularly women, who have a higher incidence of rectal prolapse.
  2. Patients who have tried non-operative management options without success.
  3. Patients with recurrent or chronic rectal prolapse.
  4. Patients with associated symptoms such as fecal incontinence, pelvic floor dysfunction, or rectal ulceration.
  5. Patients with significant discomfort, pain, or difficulties with daily activities due to rectal prolapse.
  6. Patients with a desire for definitive treatment to improve their quality of life.

It is important for patients to have a thorough evaluation by a healthcare provider to determine if rectal prolapse surgery is the most appropriate treatment option for their individual case.

Timeline

  • Before rectal prolapse surgery:
  1. Patient experiences symptoms of rectal prolapse such as feeling a bulge or protrusion from the rectum, difficulty controlling bowel movements, and incontinence.
  2. Patient seeks medical evaluation and diagnosis of rectal prolapse through physical examination, imaging tests, and possibly a colonoscopy.
  3. Patient may undergo non-operative treatments such as pelvic floor exercises, dietary changes, and medications to manage symptoms.
  4. If non-operative treatments are unsuccessful or if the prolapse is severe, patient may be recommended for surgical intervention.
  • After rectal prolapse surgery:
  1. Patient undergoes pre-operative preparations such as fasting, bowel preparation, and medical evaluation to ensure readiness for surgery.
  2. Patient undergoes rectal prolapse surgery, which can be performed through either an abdominal or perineal approach depending on the severity and specific characteristics of the prolapse.
  3. Post-operatively, patient may experience pain, swelling, and discomfort in the rectal area and may require pain medications and stool softeners.
  4. Patient is monitored in the hospital for a period of time to ensure proper healing and recovery.
  5. Patient may undergo physical therapy and follow-up appointments to monitor progress and address any complications.
  6. With successful surgery and proper post-operative care, patient can experience relief from symptoms and improved quality of life.

What to Ask Your Doctor

  1. What are the different surgical options available for rectal prolapse and what are the potential risks and benefits of each?

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

  3. What is the success rate of rectal prolapse surgery and what are the chances of the prolapse recurring in the future?

  4. Will I need to make any lifestyle changes or follow a specific diet after surgery to prevent recurrence of rectal prolapse?

  5. Are there any alternative treatments or therapies that I could consider before opting for surgery?

  6. How experienced is the surgical team in performing rectal prolapse surgery and what is their success rate?

  7. Are there any specific complications or side effects that I should be aware of before undergoing rectal prolapse surgery?

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

  9. Will I need to follow up with a specialist or undergo any additional tests or procedures after rectal prolapse surgery?

  10. What are the long-term implications of rectal prolapse surgery and what can I do to prevent future issues with rectal prolapse?

Reference

Authors: Gallo G, Martellucci J, Pellino G, Ghiselli R, Infantino A, Pucciani F, Trompetto M. Journal: Tech Coloproctol. 2018 Dec;22(12):919-931. doi: 10.1007/s10151-018-1908-9. Epub 2018 Dec 15. PMID: 30554284