Rectal prolapse repair





Definition

Rectal prolapse repair surgery treats a condition in which the rectum falls, or prolapses, from its normal anatomical position because of a weakening in the surrounding supporting tissues.


Purpose

A prolapse occurs when an organ falls or sinks out of its normal anatomical place. The pelvic organs normally have tissue (muscle, ligaments, etc.) holding them in place. Certain factors, however, may cause those tissues to weaken, leading to prolapse of the organs. The rectum is the last out of six divisions of the large intestine; the anus is the opening from the rectum through which stool exits the body. A complete rectal prolapse occurs when the rectum protrudes through the anus. If rectal prolapse is present, but the rectum does not protrude through the anus, it is called occult rectal prolapse, or rectal intussusception. In females, a rectocele occurs when the rectum protrudes into the posterior (back) wall of the vagina.

Factors that are linked to the development of rectal prolapse include age, repeated childbirth, constipation, ongoing physical activity, heavy lifting, prolapse of other pelvic organs, and prior hysterectomy . Symptoms of rectal prolapse include protrusion of the rectum during and after defecation, fecal incontinence (inadvertent leakage of feces with physical activity), constipation, and rectal bleeding. Women may experience a vaginal bulge, vaginal pressure or pain, painful sexual intercourse, and lower back pain.


Demographics

The overall incidence of rectal prolapse in the United States is approximately 4.2 per 1,000 people. The incidence of the disorder increases to 10 per 1,000 among patients older than 65. Most patients with rectal prolapse are women; the ratio of male-to-female patients is one in six.


Description

Surgery is generally not performed unless the symptoms of the prolapse have begun to interfere with daily life. Because of the numerous defects that can cause rectal prolapse, there are more than 50 operations that may be used to treat the condition. A perineal or abdominal approach may be used. While abdominal surgery is associated with a higher rate of complications and a longer recovery time, the results are generally longer lasting. Perineal surgery is generally used for older patients who are unlikely to tolerate the abdominal procedure well.


Abdominal and laparoscopic approach

Rectopexy and anterior resection are the two most common abdominal surgeries used to treat rectal prolapse. The patient is usually placed under general anesthesia for the duration of surgery. During rectopexy, an incision into the abdomen is made, the rectum isolated from surrounding tissues, and the sides of the rectum lifted and fixed to the sacrum (lower backbone) with stitches or with a non-absorbable mesh. Anterior resection removes the S-shaped sigmoid colon (the portion of the large intestine just before the rectum); the two cut ends are then reattached. This straightens the lower portion of the colon and makes it easier for stool to pass. Rectopexy and anterior resection may also be performed in combination and may lead to a lower rate of prolapse recurrence.

As an alternative to the traditional laparotomy (large incision into the abdomen), laparoscopic surgery may be performed. Laparoscopy is a surgical procedure in which a laparoscope (a thin, lighted tube) and various instruments are inserted into the abdomen through small incisions. Rectopexy and anterior resection have been performed laparoscopically with good results. A patient's recovery time following laparoscopic surgery is shorter and less painful than following traditional abdominal surgery.

Perineal approach

Perineal repair of rectal prolapse involves a surgical approach around the anus and perineum. The patient may be placed under general or regional anesthesia for the duration of surgery.

The most common perineal repair procedures are the Altemeier and Delorme procedures. During the Altemeier procedure (also called a proctosigmoidectomy), the prolapsed portion of the rectum is resected (removed) and the cut ends reattached. The weakened structures supporting the rectum may be stitched into their anatomical position. The Delorme procedure involves the resection of only the mucosa (inner lining) of the prolapsed rectum. The exposed muscular layer is then folded and stitched up and the cut edges of mucosa stitched together.

A rarely used procedure is anal encirclement. Also called the Thiersch procedure, anal encirclement involves the insertion of a thin circular band of non-absorbable material under the skin of the anus. This narrows the anal opening and prevents the protrusion of the rectum through the opening. This procedure, however, does not address the underlying condition and therefore is generally reserved for patients who are not good candidates for more invasive surgery.


Diagnosis/Preparation

Physical examination is most often used to diagnose rectal prolapse. The patient is asked to strain as if defecating; this increase in intra-abdominal pressure will maximize the degree of prolapse and aid in diagnosis. In some instances, imaging studies such as defecography (x rays taken during the process of defecation) may be administered to determine the extent of prolapse.

Before surgery, an intravenous (IV) line is placed so that fluid and/or medications may be easily administered to the patient. A Foley catheter will be placed to drain urine. Antibiotics are usually given to help prevent infection. The patient will be given a bowel prep to cleanse the colon and prepare it for surgery.


Aftercare

A Foley catheter may remain for one to two days after surgery. The patient will be given a liquid diet until normal bowel function returns. The recovery time following perineal repair is faster than recovery after abdominal surgery and usually involves a shorter hospital stay (one to three days following perineal surgery, three to seven days following abdominal surgery). The patient will be instructed to avoid activities for several weeks that will cause strain on the surgical site; these include lifting, coughing, long periods of standing, sneezing, straining with bowel movements, and sexual intercourse. High-fiber foods should be gradually added to the diet to avoid constipation and straining that could lead to prolapse recurrence.


Risks

Risks associated with rectal prolapse surgery include potential complications associated with anesthesia, infection, bleeding, injury to other pelvic structures, recurrent prolapse, and failure to correct the defect. Following a resection procedure, a leak may occur at the site where two cut ends of colon are reattached, requiring surgical repair.


Normal results

Most patients undergoing rectal prolapse repair will be able to return to normal activities, including work, within four to six weeks after surgery. The majority of patients will experience a significant improvement in symptoms and have a low chance of prolapse recurrence if heavy lifting and straining is avoided.

Morbidity and mortality rates

The approximate recurrence rates for the most commonly performed surgeries as reported by several studies are as follows:

  • Altemeier procedure: 5–54%
  • Delorme procedure: 5–26%
  • anal encirclement: 25%
  • rectopexy: 2–10%
  • anterior resection: 7–9%
  • rectopexy with anterior resection: 0–4%
  • laparoscopic rectopexy

Abdominal surgeries are associated with a higher rate of complications than perineal repairs; rectopexy, for example, has a morbidity rate of 3–29%, and anterior resection a rate of 15–29%. The complication rate for combined rectopexy and anterior resection is slightly lower at 4–23%. Approximately 25% of patients undergoing anal encirclement will eventually require surgery to treat complications associated with the procedure.


Alternatives

There are currently no medical therapies available to treat rectal prolapse. In cases of mild prolapse where the rectum does not protrude through the anus, a high-fiber diet, stool softeners, enemas, or laxatives may help to avoid constipation, which may make the prolapse worse.


Resources

BOOKS

Feldman, Mark, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 7th edition. Philadelphia: Elsevier Science, 2002.

Walsh, Patrick C., et al. Campbell's Urology. 8th edition. Philadelphia: Elsevier Science, 2002.

PERIODICALS

Felt-Bersma, Richelle J. F., and Miguel A. Cuesta. "Rectal Prolapse, Rectal Intussusception, Rectocele, and Solitary Rectal Ulcer Syndrome." Gastroenterology Clinics 30, no. 1 (March 1, 2001): 199–222.

ORGANIZATIONS

American Society of Colon and Rectal Surgeons. 85 W. Algonquin Rd., Suite 550, Arlington Heights, IL 60005. (847) 290-9184. http://www.fascrs.org .

OTHER

Flowers, Lynn K. "Rectal Prolapse." eMedicine, July 30, 2001. [cited April 9, 2003]. http://www.emedicine.com/emerg/topic496.htm .

Poritz, Lisa S. "Rectal Prolapse." eMedicine, February 6, 2003. [cited April 9, 2003]. http://www.emedicine.com/med/topic3533.htm .


Stephanie Dionne Sherk

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?



Rectal prolapse repair is usually performed in a hospital operating room . The surgery may be performed by a general surgeon, a colon and rectal surgeon (who focuses on diseases of the colon, rectum, and anus), or a gastrointestinal surgeon (who focuses on diseases of the gastrointestinal system).

QUESTIONS TO ASK THE DOCTOR



  • What defect is causing the rectal prolapse?
  • What surgical procedure is recommended for treatment?
  • What are the risks and complications associated with the recommended procedure?
  • Are any non-surgical treatment alternatives available?
  • How soon after surgery may normal activities be resumed?

User Contributions:

Maureen
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Aug 29, 2008 @ 10:10 am
Thank you for this usefull information.
Aside from having Rectocele surgey, at the same time I am having reflex bladder incontinence repair. Could you comment on this surgery too.
Thankyou
Maureen
Lindsay
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Sep 6, 2008 @ 4:16 pm
FYI There may be other treatents. Look under
Proctopexy
diana
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Jan 4, 2009 @ 2:02 am
Wow...Good info.Looks as if I will need rectal prolapse repair and I expect that small intestines may be problematic. I suspect adhesions as well as a hernia near the naval that I often have to hold when straining. To make matters worse have had lots of bad back surgery, now have pain pump which hasn't exactly solved my problems; am exhibiting many of the symptoms of MS and am due to see a Neuro Doc this month re that issue, but in the mean time I had a stomach issue, went to the ER week of Christmas, was not Gall Bladder(their suggestion), probably Ulcer. What do I need to do first and by whom? Oh, and did I mention I have arthritis in just about every joint? And I just hate to go to doctor...put it off until something just has to be done. Guess it's the opiate and anti inflammatory usage that's killed my stomach and intestines. Have been constipated for years and really just eat lots of fiber, water and laxatives (yes, lazy bowels, but without them I just don't go at all which is not a good alternative). At this point I have lots of hemmorroids which are out of the body around the opening of anus, little and larger. The bleed a bit, but nothing bad. Of late the interior or actual intestional muscle is beginning to protrude out and stay. Several months ago I prolapsed my vagina (fairly easy to do I learned as had had hysterectomy in my early years...I am now 61. I don't know if one doc could fix all my intestional problems at once or not, but great if that could be the case. Thanks in advance for your help...
Emily Segel
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Feb 21, 2009 @ 9:09 am
My daughter (now 19) had colorectal surgery for full rectal prolapse 3 years ago. It was unsuccessful and she has curtailed her activities for this as she is a competitive collegiate gymnast. She has been having impacted bowels for several months now and is now being diagnosed with the bottom of her small intestine being flattened out and possibly needing surgery to correct this. This is all the information I have right now but I am looking for the best colorectal/gastrointestinal surgeons in the country. After the first unsuccessful surgery we took her to the Mayo clinic in MN and was seen by a variety of doctors (including geneticists, gynecologists, urologists, gi's and colorectal drs). They all agreed that she should not have another surgery (at that time) to recorrect the rectal prolapse. Do you recommend taking her back to the Mayo clinic. Any and all
suggestions will be appreciated.
croft
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Apr 10, 2009 @ 2:02 am
My first child was born without a rectum so I am aware of the colosomy bags and the corrective surgeries and the reconstructions. She is ten years old now and is faced with "social continence" for the rest of her life.
I have recently been diagnosed with mucosal prolapse and went through the rectal procedure which did not work. Now they want to do the more invasive procedure in order to correct it for good, hopefully. Dealing with my daughter's issues at birth were much easier than dealing with it happening to me now. I am only thirty-one. I had all three of my children born sunnyside up which put the back of their heads against my tailbone. I have also had a histerectomy which they are saying are very big contributors to what is happening now.
zuberi
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May 28, 2009 @ 5:17 pm
also good for drs in knowing patient's concerns and hence improve communicaton skills
Jessica
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Jun 18, 2009 @ 12:00 am
Over the last four years my guts decided that they would go on strike and head south for what seems to be forever right now. I noticed that another patient that commented on this site has almost completely identical problems with me. The difference in us is I am 30 and she's 65. All of my drs say that my medical chart is that of approx a 80yr old woman. My uterus prolapsed when I was pregnant with my youngest child his growth in my womb is what held my guts in over the next 9 months. 6 weeks after he was born I went into surgery and they said that they only had to make one small cut because my uterus was almost completley ripped out. I still have my ovaries.I seemed to get a little better except I still couldn't use the bathroom for #2. I got so bad that my pelvic cavity completely prolapsed, and the drs kept pushing it back in hoping it would stay, but of course it didn't. I also found out during that time that I have early degenerative disc disease, and legions in my spinal cord which they said is either MS or cancer. On of the legions are at the base of my brain. They are leaning more toward ms because of other muscle loss of control and nerve pain. I have degeneration in literally every joint in my body. Finally my dr did a complete pelvic reconstrution and tie everything to my spine! The genious didn't review my chart before surgery. My ligaments poped dropping my guts onto a already protruding colon.causing my colon to be blocked off. Resulting then in 1 1/2 feet of colon removal, then 4 months later had to have another pelvic surgery to clean up the old site. I have also had 2 hemroid surgeries, and they still could get them all out. They said the pain would be too unbearable no matter how many times I begged them to do it all at once. Now I still can't have a bowel movement no matter how loose I can make them Still can't push them out. I end up pushing the rest of my guts out literally and tearing very tender tissues inside. I don't know what to do. I am a single mom with a collage education that I can't use because the MS makes my hands shake, and I can help peform oral surgeries.I have no family help. MY insurance has lapsed and that's when you really start to see the real side of some of these drs. I am tring to get private insurance now but its tough because a lot of this is preexsisting even though there's no final diagnosis.

The up side: Now that the Dr knows that I am getting private insurance again, They arnt making me wait one or two months to get an appoint. , and out of the blue are new treatments to try. Now I am scared to go back to them.
Jessica
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Nov 25, 2009 @ 8:08 am
Emily Segel-i too had surgery for full rectal prolapse in 2006. i went to the cleveland clinic in ohio and so far everything as worked out great. My doctor was Dr. Geisler and he was great!! I am not sure where you live, but i would definatley recommend the Cleveland Clinic. If you have any questions my email is skitty11@live.com

P.S. i was 29 when i had the surgery
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Mar 23, 2010 @ 4:16 pm
I had a rectoplexy on the 19th, and am having urinary incontinence, how long does this last? Is it due to the surgery? The surgery went well with no complications, and thus far this seems to be the only side effect. Terri
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May 20, 2010 @ 9:21 pm
I had this surgery last year. It was supposed to be laproscopic but I had just recovered from bronchitus, so it became major surgery. I would have waited to recover longer from the bronchitus and not have to have major surgery, but the surgeon did not tell me this. The colon leaked after surgery causing a severe infection, back injury, leg nerve damage from the back injury. After a second surgery, I now have a colostomy, and last but not least the doctor cut my ureter, not once but twice and lost the piece and a urologist had to repair it. The repair will probably not last and eventually I will probably also loose my kidney. I lost 8 pints of blood and was in intensive care for a week and in the hospital for 2 months. I had to go to rehab to walk and move. I now get steroid shots in my back to cope with the back and leg injuries. I also have huge hernias on my stomach with large and small intestines coming through. I also have large unexplainable deep wounds on my belly. The new doctor guesses it is where the old doctor sewed my severed colon. I had an active full fun life and I am now on disability. I have several more major surgeries to go through to try to get my body back to some normal functioning. And best part? This does not constitute malpractice!!! So, any of you out there considering surgery for rectal prolapse? Check out your doctor really well. I did not since this doctor is employed by one of the best hospitals in the world...what a mistake. And when these doctors try to complain about malpractice lawsuits? You will hear my voice.
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May 29, 2010 @ 5:17 pm
I gave my input quite a few comments ago. (see "Paulette") For everyone's information, my surgery was done by Cleveland Clinic. Yes, Cleveland Clinic is one of the best hospitals, however, they have some slip shod doctors too. Do your homework and check backgrounds and public records. I did not and I am now injured for life.
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Jun 13, 2010 @ 6:06 am
i have had surgery less than one week ago home for 3 days had what was called recum repair after hysto this 6 days after op and not done anything but sit and read no constipation or pain really but i am bleeding not a lot but fresh blood is this normal
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Jun 13, 2010 @ 6:06 am
i have had surgery less than one week ago home for 3 days had what was called recum repair after hysto this 6 days after op and not done anything but sit and read no constipation or pain really but i am bleeding not a lot but fresh blood is this normal
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Jun 13, 2010 @ 6:06 am
had surgery 6 days ago no constipation done nothing i should not started to bleed today not a lot but fresh blood
Lulu
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Jun 16, 2010 @ 2:14 pm
Emily Segel

I know this is over a year after you posted but I had the surgery and I am young and had this surgery in 2006. After spending thousands and having a few surgeries that went bad. I found Dr. Hawkins in Sommerville TN he is awesome and did my surgeries that fixed the problems. He is originally from CA. He is a christian Dr. that doesn't rush you through and he takes his time with you and does all he can to ensure his patients care is the best. I have had one problem since I have moved from TN several hours away and have traveled back to him that's how much I trust him.

Dr. Raymond Hawkins jr. MD
214 Lakeview Road
Somerville, TN 38068-9737
(901) 465-3604
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Jun 26, 2010 @ 9:09 am
I have been diagnosed with prolapse of the bowel and expect to be referred to a hospital surgeon for treatment in the near future.

I have a heart complaint and am concerned about having an operation
Please could you reassure me?

I am 78 years old but enjoy life enhancing, due to my prolapse I have now given up for the present I hope, my work at my recent Hospice which cared for my husband before his death.

I am on medication for y heart complaint after having had surgery some years ago.

I am still under the care of Barts Hospital London following the above.
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Jul 28, 2010 @ 10:22 pm
I had rectopley (sigmoidoscpy) surgery July 2, 2010. This had to be done to correct issues from a anterior 8/2 & posterior 8/5,2007 back fusion attempt (removal & replacement of hardware). After the stomache approach I have been unabl to have normal b.m's. Using digital guidance for removal. Nerve damage: entire rectum is numb w/ no signal of need to go or feeling that feces stored there like a cave, anus 75% numb, bladder retains (I self cath), vagina clit & left labia numb, etc. After rectoplexy, I had two normal bm's within first 1 1/2 weeks! Since then, the rectum has gone back to being a storage cave. I can "feel" feces passing but when look down nothing comes out. When I check, sure enough it's storing. This shouldn't be happining after this surgery. It also happens when I wake up. I was going to take a stool softener but there not hard & I'm worried that I will have leakage problems with my anus still 75% numb. Yes, that happened Pre surgery. Why would this be happening? Any suggestions?
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Aug 16, 2010 @ 11:23 pm
I was just diagnosed with a prolapsed colon, bladder. I am seeing a Ob/gyn Dr. I am 76 years old and am wondering the problems that can occur. What is the best surgery to have for this situation? Thank you.
JJ
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Aug 21, 2010 @ 6:18 pm
I believe I also have rectal Prolapse, but I'm male and 28 years old. What are the complications if I don't get this corrected? I have also had discomfort in my gut from it, but don't feel comfortable going to a doctor for it. I had Hernia surgery 2 years ago and can't believe I now have this. Could the 2 issues have a similar cause?
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Sep 1, 2010 @ 9:09 am
I have had 2 l3 thru l5 back surgeries. I have also had numberous si joint injections..I know have a prolapsed colon. This has all happened in the last 3 years. I want to know if my prolapsed colon was caused by everything I have been thourgh. I now have all the same pain I have before my surgeries. I also still have fluid on my spine.. This is a workmans comp case and it involes a hostipal..therefor I don't believe I'm recieving proper care. I haven't been able to control my bowels, since my first surgery. The colon, I'm told is in the vagina
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Sep 30, 2010 @ 12:12 pm
i am 31 year old. i am suffering with rectal prolapse since my childhood but now i have mucus discharge as well every time i feel urge to pass stool. doctors recommend me for delrome operation. i am little bit confused because in yours this article it is highlighted that the recurrence rate in delrome is more as commpared to abdominal surgery. please give me guidelines for which surgery i should go.

with regards.
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Sep 30, 2010 @ 2:14 pm
Hello, I was just diagnosed with rectal prolapse. My Dr. advised that he could correct it in 2 different ways. I am 69, and he said #1 because of my age, he recommended that I have the rectum removed from the outside. The other option is in through the abdomen, pull my rectum back up into my body, then remove about 6 inches of my colon. I am scared stiff. After reading everyone elses remarks, I do not know what to do. I cannot let it stay like this because it is painful and I cannot walk far or good due to the pressure. I also believe because the rectum is pulling downward that it could possibly be giving me the lower back pain I am getting. Mr Dr. could not comment on that. How can I investigate this Dr? How can I find a really, really good Dr. for these procedures. Any advise will be helpful. Thanks Annie
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Oct 6, 2010 @ 10:22 pm
Do stitches remain or disolve after surgery for rectal prolapse?
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Oct 24, 2010 @ 5:17 pm
I had a hysterectomy in January, My bowl has been sensitive ever since. Sometimes I just make it to the toilet and some time I don't. I thought it was just settling down from the operation

Last monday I felt I had another prolapse, went to the doctors and the muscle has collapsed and my bowel has prolapsed. I'm just devestated, I work with aged care but we have a no lifting policy. We shower and dress and feed. Hectic but no lifting at all.

My doctor wants me to try pelvic floor rather than surgery but I want Quality of life its very uncomfortable and may work in 6-8 weeks and maybe not.

Sick of crying, I was working at my health by joining over 50's excercise and water aerobics now this has happened. Is there any advise you could give me.

Many thanks Jenny
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Oct 25, 2010 @ 2:02 am
I am about to go in for a hysterectomy bladder and rectum prolapse, I have had 2 back surgeries already also suffer from mid degenerative bone disease. I do have a good Dr. Yet I live alone and all my children are out of the nest and busy with there own lives. I am nervous as the clock is ticking and have been wonder about tips to prepare for the several week following this procedure. Part of me wants to abort the notion of surgery as I am being a nervous nilly. I already am pushing my guts back in and have problems with bowl and bladder. If I don't have this done what could potentially happen? Sherry
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Nov 4, 2010 @ 7:07 am
Thanks for the info. I'm not sure if I fit the categories describing reasons for prolapse. I think it started when I had a miscarriage early in my 3rd pregnancy. As I was miscarrying I was told to empty my bladder to get a better ultrasound view. Each time we went through the ultrasound I would be sent back a second time because my bladder was not fully emptied. I had to strain to empty my bladder. Perhaps it made me start straining all of the time to empty and caused this??? Could that be?
I have never discussed this with my primary care doc. I am afraid she will not be familiar with it.
The problem seems to be getting worse.I truly do not want to have surgery or at least not general anesthesia.

Thoughts?
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Nov 4, 2010 @ 2:14 pm
How and why does over activity,cause by sexual or any other means causes rectal prolapse?
What is the best surgery to repair small and large prolapses?
How long is recovery for small and large prolapses?
Is the perineum a muscle for the anus?
What is the muscle for the anus called?
What is the charge for the violation of the anus?
Jess
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Jan 15, 2011 @ 12:00 am
I am 15 i have had a rectal prolapse for a year soon now. I have had 4 hyper sonic salene injections into the rectum. none had been successfull. this whole thing is scary for me and i dont want surgery cause im scared of them. i am thankfull that what i have isnt anything more serious. But my doctors said that i had a good chance of have the injection working and now 4 later no success. so talk to your doctor about all options. i can see how this can work for some people but it didnt for me. after the procedure i was in pain but the pain passes as time goes on, and you go home that day. At least i did. I hope this was helpfull for some people. Just remeber this happend to me cause i pushed really hard to poop. just relax and if you need to push try benefiber. it will soften things up. and really it doesnt taste bad in water. and call your doctor they are there to help you.
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Jan 31, 2011 @ 7:19 pm
I am 61, and had a full hysterectomy about 6yrs ago. Good riddance to bits and bobs that had given me years of bad periods and missing out on schooling, an ectopic pregnancy that wasn't diagnosed until 10wks (no scans those days), a number of miscarriages, 2 persistant posterior births (one with painful forceps), a ruptured ovarian cyst, blobbings, floodings, then severe pre-cancer of the uterus just behind my cervix. I miss only my cervix because I had just got remarried after 20yrs divorced, and was (pre hysterectomy) enjoying sex again - in a way I never did after it went. But it may amuse some readers to hear what my surgeon said when I said did I have to loose my cervix (as well as the one remaining ovary, and my uterus): "If I was pointing a loaded gun at you, would you remind me my flies/zipper was undone?!".
Anyway last week my intermittent bulging 'rectocele' problem (bulging rectum into vagina, despite rarely suffer with constipation) worsened after tiling my bathroom into the early hours, standing for ages, lifting WorkMate around etc, on top of doing a full time teaching job - leaving me feeling quite weird in the below-the-navel area! It culminated on Saturday evening with me ducked out of a dinner date because I couldn't walk down the road comfortably. I am OK for an hour or so when I get up, but then everything intestinal seems to head south, and I feel I should be holding my stomach up somehow to aleviate the aches... and God forbid I should need to pass a bubble of wind (excruciating!). It can feel somewhat like those Braxton Hicks contractions I used to get prior to going into proper labout... my how you remember things like that, even 35yrs on!! I went to the GP and she confirmed a rectocele by taking a quick peak ("bear down please"), and I am seeing the specialist who did my hysterectomy tomorrow morning. If he offers me pessaries or pelvic floor exercises I shall be disappointed, yet (having read all your stories) I feel really scared at the thought of surgery. Also I guess I want to hear that the rectocele is the problem due to a prolapse, and not due to something else - as recently I feel I am carting a boulder around in pelvis. However I can't really go on dreading coughing/sneezing (ouch, and can precipitate leaking wee), going over bumps when driving the car, and just feeling/looking like I am in early labour when walking around after being up for an hour or so - or when beginning to need to visit the bathroom. Maybe it was a blessing my sex life folded about 3yrs ago, because the thought of it currently is eye watering! Goodnight from across the pond to those who have shared their experiences, and thank you for tips gained from some of them, and all fond and best wishes to those for whom things are still in the melting pot from when things didn't work out. Hazel, UK
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Feb 7, 2011 @ 2:02 am
since i've had such terrible luck with drs growing up (i am 20 now) I've resorted to diagnosing myself and this seems to be matching up with what i have. I am afraid to go to the dr because of the bad experiences and injuries that everyone mentions above. how do you know if you have a dr that truly cares about you?
my symptoms have always been abdominal discomfort and constipation. throughout the years i have been taking excessive amounts of over the counter laxatives to find relief. I'm now finding out that these laxative pills can damage the nerves in your colon and intestines, numbing your urge to pass stool.
is this what a rectal prolapse is, when you never have the urge to go? i've tried everything, and have never found a good dr who can help me. this is beginning to take an emotional toll on me and i just really need some advice!!
-Denise
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Feb 14, 2011 @ 5:17 pm
which type of repair used in the rectal prolapse old patient stage 3 of American Society of Anesthesiologists
bb
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Feb 24, 2011 @ 9:21 pm
Good Information. I have had three rectoele repair surgeries within the last eleven years. The last surgery was a year ago and I have a bulge on the inside of the rectal wall again. I take stool softeners but the fecal gets in the bulge and I have to manual push out. I have pain in the pelvic area after this. I am tired of having to go through with these surgeries. Why does this keep reoccuring? Do you have any suggestions for me?
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Mar 4, 2011 @ 3:15 pm
Is there a support group anywhere in the US for people suffering from rectopexy complications?
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Mar 5, 2011 @ 8:08 am
I just had an open rectoplexy and a full foot of my large interstine removed because of prolapse. The sphintor was in danger of never working again. Everthing is going fine now and ill probably be back at my nursing job at the 8 week point. Attention- this happened because of lifting people- nurses , ask for help and use trendelenburg.
katynac
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Mar 7, 2011 @ 2:14 pm
I have had three prolapse surgeries in the past two years: rectocele; cystocele and rectopexy for intussusception. The rectopexy was one year ago. Now my rectum is prolapsing again and I'm fearful that I need more surgery. I had total hysterectomy 5 years ago and am 53.

Anyone with similar experience?

Kathy
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Mar 7, 2011 @ 10:22 pm
I had the abdominal resection and rectal retroplexy done to correct rectal prolapse and now after the surgery I can't deficate unless I take Lactaluse. What could be the problem?? Without the Lactaluse my stool is about the size of a #2 pencil and one inch in lenght. What can I have done to correct this? I can't take the medication for the rest of my life, I need to get this corrected. My doctor perscribed the meds because she was afraid that my staples would rip and open the internal surgery. It's been 14 weeks and I'm still having a problem using the bathroom.
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Mar 7, 2011 @ 10:22 pm
I had the abdominal resection and rectal retroplexy in Nov 2010 to correct rectal prolapse and now after the surgery I can't go #2 unless I take Lactaluse (perscribed meds). What could be the problem?? Without the Lactaluse my stool is about the size of a #2 pencil and one inch in lenght. What can I do to get this corrected? I can't and don't want to take the medication for the rest of my life, I need to get this corrected. My doctor perscribed the meds because she was afraid that my staples would rip due to straining. It's been 14 weeks now and I'm still having a problem with #2.
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Mar 25, 2011 @ 11:23 pm
have had surgery for rectal prolapse... which went well however I am in so much pain, my medication is as follows Diclofenac Sodioum 3 50mg tablets 3 times a day along with Paracetamol 2 tablets 4 times a day can I increase the Diclofenac ? or is there a stronger painkiller other than Paracetamol that I can take hope that you can help
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May 2, 2011 @ 9:21 pm
I have found this information very helpful. I have to go through the redo again ASAP! and have a net put in.
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May 7, 2011 @ 6:06 am
Cronic Stomach Problem

My name is Girish,
weight-46, age-28, height-5'9", working as a DTP operator, (Computer work)

Main topic :
Before 10 to 15 year ago, when I was near 15 to 20 year
I was entered a round plastic (rounding 1' or 3/4') in to my anal and
entering in my back side (anus approx. much more I can) and I do this
activity in many time. I think that this activity very harmful my rectum area,
destroy my rectum motality.

I want to do yoga, running, exercise, but not evacuation properly,
not become pressure and all time feel very heaviness, loss of appetide.
gas, not eating properly, feel weakness, Before 10 year
I take lots of medicine : Like : dulcolex, harad, aloevera, amla, triphala,
isabgol, cremafine, amaltas, papaya, guava, saup, ginger, (kismis, anjeer,
mixed with mil and drink and many more medicine.

I treated in aims continuous two months and do many more test like
enema barium, three blood test, throid test, stool test,
three times altrasound but all reports OK not get any disease.

Sir, I going to slowly slowly in the mouth of death, Please help me.

Thanks!
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May 7, 2011 @ 5:17 pm
can patients have rectal suppositories post ventral rectopexy
Liz
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Jun 27, 2011 @ 4:16 pm
You have answered both question on Cystocele repair and rectal prolapse for me. I can now ask the questions and schedule my life around the surgery coming up. Being prepared after you read/hear the word surgery still sends some adults into the freeze mode. Information provides choices and removes blindfolds. The symptoms described were to a tee, my daily life has changed so much because of this problem(s). I had put this surgery off once before, but now I feel confident and can proceed.
Polly Mac
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Jul 22, 2011 @ 1:13 pm
Sirs: NEED NAME OF BOARD CERTIFIED PLASTIC SURGEON THAT CAN REPAIR A RECTOCELE THAT WENT WRONG
in CORPUS CHRISTI, TX AREA

PLEASE, PLEASE
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Aug 30, 2011 @ 12:12 pm
I had a baby five months ago which cause 2nd degree rectcile prolaps and recently I fell pregnant again but had a miscarage, could the prolaps of caused this.
lookingforhelp2
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Sep 1, 2011 @ 10:10 am
Jess. My daughter is 12 and has rectal prolapse. Have there been any changes in your condition since you posted?
Kelly
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Sep 21, 2011 @ 8:08 am
I am 28year old woman who has been suffering from rectal prolasp for 10 years now. At first I thought it was hemoroids, because my doctors never diagnosed me with any else. Until recently I was searching on the internet and now know that I have an internal prolasp as well. When I stand or sit for a long period of time my anal feels hot and it leaks out gas and create sweat marks on my pants. The strange thing is that the gas problem happens more often when I am out, nervous, or stress, or eat spicy food. The problem is more controllable at home, most of the time I just feel heavy and discomfort in the rectom, but not so much hot unless I eat unhealthy food. I have had 2 hemoriods surgeries already and want to avoid anymore surgery... can someone please help?
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Oct 25, 2011 @ 10:10 am
10 years ago I had an ecoli infection. This has left me with a dragging pain on my left side as well as leakage from my rectum. Last year I was diagnosed with a low grade intussussception which may need a rectopexy. The Dr advised me to think about what I wanted to do. The leakage is my biggest concerned, it can just happen, but I have found that spicy food and stress makes it worse. I originaly went to see the Dr as I had had enough of my sypmtons. I have tried looking on the internet but I really can't find any information that will help me to make my decission. Any advise?
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Nov 4, 2011 @ 5:17 pm
hallo for two yars i have followed the st marck ospital beacouse of serus difficulty to evaqetion
after 20 monts of test en biofedback unprofechional en in competant,maby beacouse i'm italian
fter this unbiofeedback the specialist#maby#is riteng me 47 yars since appendicectomy hemorrids,laparoscopy,,adesions his bowel open evry days by digitascion figher en evaquetion is incoplit en is soffer every days we send to surgery,the surgeonis only put me on theatre ward for
ligation of mucosas prolaps en banding emorrhoyd,en this unuman parson as surger is ried me paipars wich tel my =you soffer of severity contipation for mucosas prolaps en rectal inintusussception if u wesch ypu after loock foor surgery foor a starr procedure not in this ospital i'm sorry go back to yor gp colorectal surgeon doctor jankins.Wat u thick abaut this unusual tretmant i have obstruction very serusy iven the lacsativ do not halp my i'm very desparait wat hospital is able foor my problem .CLAUDIO FROAM LONDON #i'm not englesc ther is cure foor me# tanks
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Nov 14, 2011 @ 4:16 pm
i think in this contry the colorectal surgeon the do not give schit abaut awur disese if you have mney,bat money in 5 zero in yor bank accout maby the find you at waey to stop costipation en schitting every day ,in different case is only dreem,in u.k the do not care abaut uman been halt expecialy if you caming forom abroud,pals officer in this contry the are criminal the do not care,if you lose yor halt this mather facker quens contry is the worst place to be curet
the goverment are criminal en wat you can aspact froam criminal only bull schit,fack you england en all quins rich this contry the kill you if you hare halty en in good stile ,immagin if you are seck en you asck foor hap to be cure the esay way is ran off england notting is god in this criminal contry.
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Nov 23, 2011 @ 5:05 am
I am from the uk and just had a bladder and rectal repair and repair of the cervix from a previous hysterectomy, i just want to know when the bleeding should stop as its been three weeks now, i also want to know when i can drive and return to work and have sex again? No one seems to be able to tell me.
Rose
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Jan 9, 2012 @ 11:23 pm
i dont know if you experience farting small amounts of air but i feel that i always need to go...i had colonoscopy they said everything is normal...but why do i always fee something is irritating my rectum...do you think i have internal prolapse?pls give me some advice...May God help us all
Misty
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Jan 24, 2012 @ 12:12 pm
What is causing pain on right side just above pubic bone following colorectal surgery for rectal prolapse and partial removal of sigmoid colon? Performed late May 11'. TAH performed April 02'. Most recent colonoscopy performed Aug 11'; removed 4 benign polyps. DOB 1-19-72 Should I be concerned?
Donna
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Feb 1, 2012 @ 12:00 am
Iv just had this now can't wee by myself is this a bad thing
helen
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Mar 30, 2012 @ 3:03 am
Im due to have this surgery in july. ive had 4 different ops upto now and have been pretty straight forward. the info on this site has really helped me. not looking forward to the surgery but i just hope its going to sort me out
debs
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Apr 3, 2012 @ 5:05 am
i am geting an EAU done as my doc thinks i am suffering from rectal prolapse , i was diagnosed with ibs and have loads of ulcers through my bowel i am 33 now but have had bowel troubels fo 20 years and just want an ens to it as i cant lead a normal lifestile as i can go for a no 2 about 20 times a day i take imodeum and predfoam enemas but not much helo realy , reading these articals i am now scared of having the prolapse fixed as there seam to be so many things can go rong !!
Lisa
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May 14, 2012 @ 8:20 pm
interesting information regarding this condition. it does not mention anything about "reverse catherization"
Bonnie
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Nov 30, 2012 @ 7:07 am
I had bladder slig and rectal seal surgery on mondy this week and to day is Friday and still have not had a bowel movement yet
is this normal or what .
Ann
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Mar 3, 2013 @ 1:13 pm
People ask questions but I do not see the replies? I have a Prolapsed Rectum and having surgery this month, DR reckoned although I am a young 80 yr old active, etc, the surgery will be done through the abdomen, he did offer through the Rectum but he said for me the other way would be better, now I am not sure? I know one is longer in hospital with the abdomen, which turns me off. No ne seems very happy qwith either situation.

Ann
Judi
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Jun 13, 2013 @ 9:21 pm
I had open rectopexy surgery on May 30th. In the two weeks since my surgery, I have not yet had a normal bowel movement. Only tiny bits of fecal matter slip out, and I often cannot control when this happens. I have no ability to "push" to try to go to the bathroom. Also, I find it difficult to urinate. Anyone else have these complications after their surgery?
Judi
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Jun 14, 2013 @ 1:01 am
I had open rectopexy surgery on May 30th. In the two weeks since my surgery, I have not yet had a normal bowel movement. Only tiny bits of fecal matter slip out, and I often cannot control when this happens. I have no ability to "push" to try to go to the bathroom. Also, I find it difficult to urinate. Anyone else have these complications after their surgery?
Neeza
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Jul 20, 2013 @ 1:13 pm
My sister has had a Rectal Intussuception operation recently, and she is complaining of severe trapped wind/cramps, Does any one know if this is normal, and she finds it hard to go to the bathroom.
Has anyone been advised of what to eat or drink?
kelly
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Aug 5, 2013 @ 1:13 pm
Looking for a support group for rectovaginal fistula/failed colorectal vaginal repair, just had my second repair attempt and I am certain it failed. Going for followup and will know more in two days.
Bill
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Nov 1, 2013 @ 10:10 am
I have a relative that is also going through Stage 3 Bladder Cancer treatment. She will have the Perineal /Altemeier procedure done prior to the bladder cancer treatment. Can anyone comment on the risks and considerations. Sounds like Bladder removal after this surgery would be a risk.
Eureta
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Mar 22, 2014 @ 8:08 am
I have been undergoing a long list of testing. Being a retired nurse I have done a lot of research. The doctors that I am going to are eurogynecologist. There are only about 7 in Houston where I live and mine is one of them. The amount of testing that they have done has been amazing. My next appointment will be for consultation about the procedure that will be done. I know that I have rectal prolapse (rectocele) and a cystocele. Not sure about falling bladder. After reading about all the problems that people have had after surgery it is beginning to make me apprehensive about having surgery. However on the positive note I would be going to the best for the surgery. I would also be having the surgery in the Houston Medical Center which would be Texas Women Hospital which is state of the art. Please give me your input.
Rox
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Jun 26, 2014 @ 6:18 pm
I am having the rectal prolapse surgery in a couple of days. I too am looking for advice from those who have had the surgery. I do not see any replies. Reading your stories, I am terrified. My doctor is very informative, but I don't really know what to expect after surgery. Is everyone numb? He did say it may take many months to be back to normal. Thank you ...
Susan Harbuck
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Jul 13, 2014 @ 5:17 pm
I had Rectal Prolapse Repair surgery on June 17, 2014. My question is when will the abnormal bowel movements stop? I am now taking fiber 5 grams and a stool softener one time a day. Can anyone give me any ideas as to what to do? The other question is I was told there is a shot the doctor can give you to stop the leakage in the bowels. Does anyone know anything about the shot? Thank you for your help.
Justyne
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Sep 2, 2014 @ 9:21 pm
I had Rectal surgery repair 5 yrs ago and found it has failed again. The doc suggested I use a dildo when I have to have a bowl movement to help with movement. Has anyone found something that works? I have increased my fiber and even take a supplement, and I take 2 doses of stool softeners aday. He told me to use my fingers in my vagina or find a dildo and insert it when I have to go or wear one during the day to help things move closer to the exit.

I am to young to have this surgery again and in the future have to do it again, very frustrated and embressed
nelly
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Sep 9, 2014 @ 4:16 pm
Hi, I need surgery for rectal prolapse. I live on a British Island. I have been on a waiting list for two years and I am nowhere near being seen by a professional. I would like to know which reliable UK hospital takes international clients on a private basis for this type of surgery. Thanks
Kathy
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Sep 25, 2014 @ 8:08 am
I had a sigmoidectomy and rectoplexy surgery done two weeks ago. I am still in a lot of pain. Is this normal? I thought the pain would have lessened a little bit by now, but it's still bad. I was taking Tramadol for the pain, but it constipated me so much, I stopped taking it. I am only taking extra strength Tylenol now, which doesn't help the pain very much, but now I can move my bowels. I had open surgery. Surgeon said he tried, but could not do everything he needed to do laproscopically. I just need to know if this much pain is normal two weeks post-op? Nurse in Dr's office told me yesterday it would get better, but I don't notice any improvement.

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