Surgical Treatment of Rectal Prolapse

Rectal prolapse happens when the rectum (the last section of the large intestine) loses its normal attachments, causing it to slide out through the anal orifice and turn inside out.

There are 3 types of prolapse that are referred to as “rectal prolapse”:

  • The whole rectum protrudes out of the anus
  • The rectal lining is only partially pushed into the anus
  • The rectum begins to descend, but it does not stretch beyond the anus

Rectal prolapse primarily affects adults; however, women over 50 are six times more likely than males to get it, says Dr. Purnendu Bhowmik, a famous rectal prolapse specialist. It is humiliating and frequently has a negative impact on patients’ quality of life.

rectal prolapse surgery
rectal prolapse surgery

Are rectal prolapse and haemorrhoids the same thing?

No. Rectal prolapse is caused by slipping of attachments of the final section of the large bowel. Haemorrhoids are enlarged blood vessels that form in the lower rectum and anus. Anal itching and soreness, irritation, and bright red blood on toilet tissue are all symptoms of haemorrhoids. Internal haemorrhoids that have slipped out of the anus (prolapsed) might make early rectal prolapse difficult to distinguish from internal haemorrhoids.

How do you know that you have rectal prolapse?

Rectal prolapse presents itself in a variety of ways. The sensation of a bulge or the appearance of a reddish-coloured mass that extends outside the anus is a sign of rectal prolapse. This is a transient condition that can occur during or after bowel movements. The extremity of the rectum may stretch out of the anal canal unexpectedly over time as a result of normal standing and walking and need to be forced back up into the anus by hand.

Rectal prolapse can also cause pain in the anus, as well as bleeding from the rectum’s inner lining. These symptoms are rarely life-threatening.Another symptom experienced is faecal incontinence.

What our patients say

What are the causative factors?

Rectal prolapse is assumed to be caused by a variety of circumstances, although there is no definitive “cause.” According to the rectal prolapse doctor, chronic constipation (infrequent stools or intense straining) affects 30 percent to 67 percent of patients, while diarrhoea affects another 15%. Previously, it was thought that this disease was linked to multiple vaginal deliveries. However, up to 35% of people with rectal prolapse never gave birth, and it can affect men as well. Diabetes, chronic obstructive pulmonary disease, cystic fibrosis,hysterectomy and parasitic infections in the intestines can all induce rectal prolapse.

How is it diagnosed?

Your doctor will begin by taking your medical history and performing a rectal examination. To simulate a genuine bowel movement, you may be instructed to “strain” while sitting on a commode. Your doctor will be able to confirm the diagnosis and plan therapy if you can see the prolapse.

The following are some of the diagnostic tests:

  • Videodefecogram: It is an X-ray that is obtained while you are having a bowel movement to check muscle action.
  • Anorectal Manometry: Assesses the anus, pelvic and rectal muscle functioning and reflexes during bowel motions.

How is it treated?

Rectal prolapse treatment can begin at home in certain modest cases by using stool softeners and manually pushing the fallen tissue back up into the anus. However, in most cases, surgery is required to fix the prolapse.

There are a number of surgical treatment options. The surgeon’s decision is based on the patient’s age, other health issues, the amount of the prolapse, exam and other test results.

Abdominal repair procedure

The abdominal rectal prolapse repair involves making an opening in the abdominal muscles to examine and perform the operation on the abdominal cavity.

Rectopexy (rectum fixation by open or laparoscopic method) and resection (excision of a section of intestine), which isfollowed by rectopexy are the two most prevalent methods of abdominal repair.

Perineal (rectal) repair procedure

Rectal procedures are frequently performed in patients who are older or who have more health problems. The Altemeier and Delorme procedures are the two most prevalent rectal approaches:

Altemeier procedure: The section of the rectum protruding out of the anus is amputated and the two ends are sewed back together in the Altemeier surgery, also known as a perineal proctosigmoidectomy.

Delorme procedure: Only the inner surface of the falling rectum is removed in the Delorme operation. After that, the outside layer is folded and stitched, and the inside lining’s cut ends are stitched together.

What is the success rate of rectal prolapse surgery?

Success varies depending on the state of the supporting tissues as well as the patient’s age and health. When compared to perineal treatments, abdominal surgeries have a lesser risk of the prolapse returning. Surgery usually resolves the prolapse in the majority of patients.

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