Rectal Prolapse surgery in Hyderabad

Rectal Prolapse is a condition in which the rectum (end section of the large intestine) or a part of it, slip down from its normal place, and extrudes out of the anal region. While it is not always an urgent problem. However, if the condition is for long period, it can get worse and make the patient discomfort and cause anxiety, with an adverse effect on the quality of life. Rectal Prolapse is mostly common in women (particularly above 50 years) than in men.

TYPES OF RECTAL PROLAPSE

PARTIAL OR MUCOSAL PROLAPSE: Particularly the inner lining of the rectum extrudes through the anal region. It is generally more than 2cm and creates radial folds.

FULL THICKNESS RECTAL PROLAPSE / PROCIDENTIA: It is a part of the wall ( with all three layers ) that extrudes within the anus. It is approximately 2-5cm and creates concentric hoops.

OCCULT or INTERNAL INTUSSUSCEPTION: The rectum collapses on itself but does not obtrude into the anus.

CAUSES OF RECTAL PROLAPSE

Constipation with a history of straining to excrete.

Chronic diarrhoea

Old age - Due to indulgence of the pelvic diaphragm muscles and diminished anal sphincter condition.

Pregnancy, complicated vaginal births.

Chronic cough

Neurological conditions like various sclerosis, damage to the lower back or pelvis, spinal neoplasms.

Cystic fibrosis in children

SYMPTOMS OF RECTAL PROLAPSE

The most common symptom is swelling that comes out near the anal opening. In the initial stages, this could happen during regular bowel movements, but as the condition advances it can happen while coughing, sneezing and as well as standing up.

In the case of Hidden prolapse, there is no lump coming out but there can be a sense of incomplete discharge after a bowel movement, as something is left inside the rectum.

Fecal incontinence leading to soiling of clothes.

Constipation

Pain/ discomfort in the region.

By the time, prolapsed mucosa generally become dense and ulcerated causing blood loss.

DIAGNOSIS OF RECTAL PROLAPSE

A digital rectal examination is performed followed by Proctoscopy ( visualisation of the rectum by inserting a scope ).

Other tests may include

MRI Defecography - This test shows how much stool the rectum can hold, how well it can hold and how well it can release the stool.

Colonoscopy - This is an examination of the large intestine/colon, with the help of a flexible tube that has an inbuilt camera. It is done to rule out any associated condition.

Anal manometry - This test measures the strength of the anal sphincters, how tightly the sphincters can close.

Treatment of rectal prolapse

Although surgery is not always required, the definitive treatment of rectal prolapse requires surgery. The purpose of the procedure is to restrict prolapse, restore excretion function and prevent it from causing constipation or incontinence.

I SURGICAL TREATMENT OF RECTAL PROLAPSE

There are various surgical procedures to restore rectal prolapse. It is best to leave the final decision about the choice of the procedure with your surgeon. It is the surgeon's which technique is used for the surgery, depending upon the patient's age, other health difficulties, the extent of the prolapse, test results and the surgeon's choice with specific techniques.

Primarily, there are two common ways for the surgery of rectal prolapse:

Abdominal way - It is done through the belly.

Perineal way - Through the bottom.

II TREATMENT OF COMPLETE PROLAPSE - PROCIDENTIA

THIERSCH PROCEDURE

This procedure is simple in which a prosthesis is used, that narrows the anal. A silver wire is used, and silicon rubber elements are used.

This method corrects the prolapse, it has no impact on consolidated constipation if it is present. This constipation is controlled with diet and lifestyle corrections.

RECTOPEXY ( Abdominal/ Laparoscopic )

In this method, the loose rectal attachments are divided from the pelvic walls all the way to the floor of the pelvis. A rectopexy is then performed, whereby the rectum is pulled upwards and secured back to the wall of the pelvis in various ways. At times, this procedure is accompanied by resection of a portion of the bowel. Rectopexy is a major surgery done under general anaesthesia.

Dr Anuj Kumar Patel

Dr Anuj Kumar Patel is a General and Laparoscopic Surgeon who holds an experience of 10 years in the field of proctology. More than 1000 proctology surgeries and laparoscopic surgery he has been performed. Dr Patel’s surgical skills, diligent behaviour and kindness towards patients are the qualities that surely make him an ideal doctor.

Website. https://www.healinghandsclinic.co.in/treatment-of-prolapse/