Rectal Prolapse Surgery in Turkey

Rectal Prolapse surgery

Rectal prolapse through the anus causes unpleasant symptoms that require treatment. Rectal Prolapse surgery can be performed using minimally invasive surgical techniques in Turkey.

What is rectal prolapse?

Rectal prolapse happens when the rectum drops out of its normal place downward. The patient may notice his rectal prolapse during defecation or when standing as it takes the form of a red lump protruding from the anus.

The rectum separates the last parts of the colon from the anus, and constitutes a temporary storage for stools until they are excreted from the body ..

Rectal prolapse is a common condition in elderly people who suffer from chronic constipation, and it occurs more often in women after menopause and may affect young children as well.

The rectum is often returned to its normal position by surgery, and currently the surgery is performed in Turkey with advanced minimally invasive techniques with low risk.

rectal prolapse pictures
Rectal prolapse with illustrations

 Symptoms of rectal prolapse

The most common symptom of rectal prolapse is being able to notice the descending rectum as a red mass protruding from the anus, this mass is especially noticeable during defecation and with the development of the condition it becomes visible when standing and walking.

Other symptoms of rectal prolapse include:

  • Bloody defecation and pain during defecation
  • Stool incontinence (lossing control over the process of defecation)
  • Feeling the urge to defecate even though there is no stool
  • Constipation or diarrhea
  • Passing mucus or pus with stool

Causes of rectal prolapse

The main cause is still not clearly understood, some doctors believe that the cause of rectal prolapse is the weakness of the muscles that keep the rectum in place, while others believe that rectal prolapse occurs in women after childbirth.

Scientists agree that there are several factors that play a role in developing rectal prolapse, including:

  • Chronic constipation or diarrhea
  •  Neurological injury to the nerves responsible for contracting the rectal and anal muscles
  • Severe pressure during defecation
  • Previous traumatic injury to the pelvic area around the rectum
  • Infections at the anal and rectal level
  • Some diseases such as cystic fibrosis or diabetes
  • it might be associated with uterine prolapse or the vagina prolapse

Diagnosis of rectal prolapse

The doctor asks for the patient’s medical history. The presence of chronic constipation may increase the suspicion of the possibility of rectal prolapse.

The doctor must be aware of the difference between rectal prolapse and hemorrhoids, as they are two different medical conditions. The doctor may use one of the following tests to confirm the diagnosis and rule out other causes:

Rectal examination (anal palpation): The doctor wears gloves and inserts his finger through the anus into the rectum. The strength of the anal sphincter is evaluated and the doctor will search for any abnormalities, or bleeding.

Anal manometry: It is done by inserting a narrow flexible tube which contain a balloon at the bottom of it into the rectum, the balloon is inflated and the strength of contraction of the anal sphincter is measured.

Anal electromyography: This test is useful to determine if the cause of rectal prolapse is a defect in the innervation of the anal sphincter muscle.

colonoscopy: It is used to rule out other causes such as polyps or tumors in the large intestine. A flexible tube containing a camera is inserted through the anus to view the large intestine.

Read more about colonoscopy.

defecation radiography: This test is based on radiographic video recording the rectum and anus during defecation in order to study the presence of any functional problems during defecation in the rectum.

Rectal Prolapse Surgery in Turkey

Surgery is often the best way to treat rectal prolapse in adults. The surgery aims to return the rectum to its normal position, and is carried out by surgical techniques aimed at repairing or strengthening the rectal septum.

Rectal prolapse surgery can be done in 2 different methods:

Transabdominal surgery

 Surgical incisions are made in the abdomen to fix the rectum into its normal place. if the patient has a long history of constipation, the surgeon may resort to removing part of the colon and then returning the rectum and fixing it in its normal position.

Transabdominal surgery is performed for healthy patients who do not have chronic diseases.

Transperineal surgery

This surgery is used for older patients who have health problems that make abdominal surgery difficult to perform. There are two surgical techniques available:

Altemeier procedurethe descending part of the rectum is excised, and then the two ends of the rectum are sutured together.

Delorme procedure: The inner lining of the descending rectum is removed, then the two ends of the inner lining are sutured together, and then the outer layer of the descending rectum is folded and returned to its normal place.

Minimally invasive rectal prolapse surgery in Turkey

Surgical methods have developed throughout the years, as modern technology has recently appeared which has low-risk and easy to preform, such as the use of robots for surgery.

Turkey has provided the latest treatment methods to for rectal prolapse surgery, including:

Laparoscopic rectal prolapse surgery

After the patient is anesthetized, the surgeon makes a small incision in the abdomen and then inserts the laparoscope (which is a tubular device that has a camera at the bottom).

The doctor locates the sigmoid colon and rectum to seprate it from the surrounding tissues and return the descending rectum to its normal position.

Comparison between rectal prolapse and normal condition after rectal prolapse repair
This picture shows the results of rectal prolapse repair

Robotic rectal prolapse surgery

With a robotic device that is controlled by the surgeon, the surgery can be performed with great accuracy, with a clear three-dimensional vision, and with the least possible risk.

You can watch a video of the surgery at Here.

Advantages of Minimally Invasive Rectal Prolapse surgery

The advantages of minimally invasive rectal prolapse surgery are:

  • Less chance of complications
  • less blood is lost compared to a normal surgery
  • Quicker recovery after the surgery, as the patient returns to his normal life within a short period of time
  • The results are better than normal surgery
  • Less surgical scars
  • less pain

After Rectal Prolapse surgery

how long does the patient stay in the hospital depends on the type of surgery that was performed. In the traditional open surgery of the rectum, the patient stays in the hospital for about 5 to 8 days, and this period is less when using less invasive methods such as laparoscopy.

You must drink plenty of fluids after the surgery, and the doctor may prescribe stool softeners during the recovery time, along with a diet rich in fiber for the weeks following the surgery to avoid constipation, which may lead to a recurrence of rectal prolapse again.

Most patients return to their normal lives within 4 to 6 weeks of surgery, and symptoms often resolve completely in the vast majority of patients.

How to treat rectal prolapse without surgery

As mentioned earlier, the primary method for treating rectal prolapse is surgery, but it is possible to use other methods that help treat rectal prolapse in its initial mild stages, such as herbs and physical therapy.

Herbal treatment for rectal prolapse

Patients with rectal prolapse are advised to eat a lot of food rich in fiber, especially fruits and vegetables, to avoid constipation, which negatively affects the prolapse. Among the herbs that have a role in managing constipation and treating rectal prolapse: ellipsoid, raisins, nigella, chamomile, ginger.

The effectiveness of herbs in treating rectal prolapse has not yet been clearly demonstrated, and studies are still being conducted on this type of treatment.

exercises for Rectal prolapse

There are some exercises that are useful in strengthening the muscles of the pelvic floor, as these muscles work to support the uterus, bladder and rectum to prevent organs from drooping downward. The most important of these exercises:

Kegel exercises

Sit or stand in a comfortable position with your legs spread apart, then and pull the muscle as if you are trying to prevent the passage of gas from the intestines.

Imagine yourself as if you are about to urinate and then tighten the muscles that you use to stop peeing, pulling the pelvic muscles from the back and forward as best as possible.

Hold this position for about ten seconds and then relax the muscles, rest for about 5 seconds and then repeat this exercise for several times in a row.

Manual rectal elevation

Wash your hands well, put on your gloves, and then insert your finger to the place of the descending rectum and apply pressure on it and pull it up gently. Repeat this process several times in a row.

Stop performing these exercises if you feel pain, consulting a specialist is the best option in all cases, the specialist will teach you how to perform these exercises at home if you need them.


Sources:

  1. Mayo clinic
  2. Cleveland Clinic
  3. Webmd

Common Questions

Rectal prolapse results from an internal organ drooping out of its normal position, while hemorrhoids are vascular dilatations in the anal and lower rectal veins.

rectal prolapse is not considered a dangerous condition, but it may be associated with unpleasant symptoms for the patient, which calls for treatment. When the condition is neglected and not treated, some serious complications such as bleeding and ulcers may occure.

There are risk factors that increase the risk of rectal prolapse in women, including:
  • A long history of constipation or diarrhea
  • Severe pressure during defecation
  • Some chronic diseases such as cystic fibrosis
  • Spinal cord problems or a previous stroke
  • aging
  • childBirth

Rectal prolapse is often treated with a surgical procedure aimed at repairing the prolapse and returning the rectum to its normal position.

Rectal prolapse surgery is done either by open surgery through the abdomen or perineum, or by minimally invasive techniques such as laparoscopic or robotic surgery.

It might be possible to teat the prolapse by washing your hands well and wearing gloves to apply pressure on the prolapsed rectum and try to gently lift it upwards. This procedure may help in reducing the degree of prolapse, but it is not considered a definitive treatment for the disease. It is preferable to consult a doctor before starting this procduer.

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