Our Summary

This research paper examines trends in hospital admissions and surgeries for rectal prolapse in adults in England between 2001 and 2012. Rectal prolapse is a condition where the rectum, the last part of the large intestine, slips outside the anus.

The researchers analyzed data from 25,238 adults over this period who underwent 29,379 operations for rectal prolapse. The average age of these patients was 73, and the majority (a ratio of 7:1) were women. The average length of their hospital stays was three days, and less than 1% of these patients died in the hospital.

The study found that the number of admissions and surgeries for rectal prolapse increased significantly over this 11-year period. Specifically, admissions rose from 4,950 in 2001/2002 to 8,927 in 2011/2012, and surgeries increased from 2,230 to 2,808 over the same period.

The use of laparoscopic surgery, a minimally invasive surgical technique, increased 15-fold during this time. The recurrence rate of rectal prolapse after surgery was 12.7% overall. The lowest recurrence rate (9.1%) was observed for open resection, a type of surgery where a portion of the rectum is removed, but this type of surgery had the highest death rate (1.9%). Laparoscopic and perineal fixations, another type of surgery, had low recurrence rates (less than 11%) and the lowest death rates (0.3%).

The study concludes that admissions and surgeries for rectal prolapse increased in England between 2001 and 2012. The researchers suggest that the types of surgeries used to treat rectal prolapse may have changed over this period, which could be reflected in the outcomes.

FAQs

  1. What is rectal prolapse and how is it treated with surgery?
  2. Has the number of hospital admissions and surgeries for rectal prolapse increased over the years in England?
  3. What are the recurrence and death rates for different types of surgeries for 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 promote healing and reduce the risk of complications. This may include taking prescribed medications, avoiding heavy lifting or strenuous activities, eating a high-fiber diet to prevent constipation, and attending follow-up appointments with your healthcare provider. It’s important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as dietary changes, pelvic floor exercises, and medications without success. Surgery is usually recommended for patients with severe symptoms such as chronic rectal prolapse, fecal incontinence, and significant discomfort or pain.

Additionally, patients who are in good overall health and able to undergo surgery are typically considered good candidates for rectal prolapse surgery. Age is also a factor to consider, as older patients may have a higher risk of complications from surgery.

Overall, the decision to recommend rectal prolapse surgery is made on a case-by-case basis by a healthcare provider after considering the patient’s symptoms, overall health, and the potential benefits and risks of surgery.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as difficulty controlling bowel movements, a feeling of a bulge or protrusion from the anus, pain or discomfort during bowel movements, and rectal bleeding. These symptoms can significantly impact a patient’s quality of life.

After rectal prolapse surgery, the patient can expect to spend a few days in the hospital for recovery. They may experience some pain, discomfort, and swelling in the surgical area. It is important for the patient to follow their surgeon’s post-operative instructions, which may include taking pain medication, eating a soft diet, and avoiding strenuous activities.

Over time, the patient should experience improvement in their symptoms and quality of life. The recurrence rate of rectal prolapse after surgery is relatively low, but it is still important for the patient to follow up with their healthcare provider regularly to monitor their condition. In general, most patients report a significant improvement in their symptoms and overall well-being after undergoing 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 different surgical options available for treating rectal prolapse?
  2. What are the benefits and risks of each type of surgery?
  3. How long is the recovery time for each type of surgery?
  4. What is the success rate of the surgery in terms of preventing a recurrence of rectal prolapse?
  5. What are the potential complications of the surgery?
  6. How many of these surgeries have you performed, and what is your success rate?
  7. Will I need to make any lifestyle changes after the surgery?
  8. How long will I need to stay in the hospital after the surgery?
  9. What will the follow-up care involve after the surgery?
  10. Are there any alternative treatments to surgery for rectal prolapse that I should consider?

Reference

Authors: El-Dhuwaib Y, Pandyan A, Knowles CH. Journal: Colorectal Dis. 2020 Oct;22(10):1359-1366. doi: 10.1111/codi.15094. Epub 2020 May 28. PMID: 32346972