Rectal prolapse is a condition where lower part of rectum or big intestine slips from its base and in some severe cases may also protrude outside the anus. The anal spinchter muscle holds the rectum in place which may becomes loose and weak due to some reason. This leads to rectal prolapse.
Various causes of rectal prolapse include ageing, persistent constipation requiring pressure exertion while defecation, diarrhea, pregnancy, surgery around the rectal region, paralysis and multiple sclerosis. A physical examination is enough to establish this medical condition and there are various options to set it right. In this write up we will discuss these treatment options.
Treatment Options For Rectal Prolapse
Ones the external rectal prolapse takes place, the only option is surgery. However, in the initial stages and among the children non-surgical treatment is preferred. The course of treatment is usually to cure the underlying cause of rectal prolapse.
For e.g. diet modifications and medication prescription for constipation, diarrhea, multiple sclerosis etc. This is also considered the best option as there is no invasion and the treatment aims to eliminate the base cause of this medical condition. But as mentioned earlier, it is only in mild and initial stages that this can be done.
Open Abdominal Procedure
In this procedure the penetration is through abdomen. It is extremely invasive and also carries a risk of male impotence. The pelvic cavity is opened to reach the rectum under open procedure. The healing time taken is quite long and there is high risk of other organ damage too under this procedure. Abdominal procedure is done on younger and sturdy patients as the rate of recurrence is low and patients enjoying good health can physically accept this surgery better.
There are various types of surgical procedures that can be used to treat and set right rectal prolapse based on the technique and level of invasion inside the body.
In this segment we will discuss all of the surgical options available for people suffering from rectal prolapse.
Laproscopic Abdominal Procedure
In this procedure too, the access to rectum and its surgery is done through abdomen. However, the difference is that instead of cutting open the entire abdomen, there are small incisions through which a camera and surgical equipment is inserted inside.
There is minimal cutting and the whole procedure is done by monitoring the insides on a screen. Though this is also an invasive procedure, the damage is minimal. The healing time after surgery is also mush lesser than the open abdomen procedure.
In this procedure the redundant part of prolapsed rectum is removed by incision and remaining part is reconnected to build the entire rectum. The remaining part is connected with the anus and supported through stapling and stitches so that it holds itself in place.
There may also be levatorplasty which aims at tightening the muscles supporting rectum to avoid future recurrence of this condition.
In this procedure, instead of removing the redundant part of prolapsed rectum, only the mucosa is removed. The protrusion is pushed back and then mucosa is stitched in a way that it supports and keeps the rectum in place.
It is best suited for partial rectal prolapse. This procedure does not cure or treat the base cause of this condition but may alleviate symptoms like bleeding, fecal incontinence and pain during bowel movement.
This procedure is least invasive but does cure the base cause. The rectum is folded back and a suture or a stitch is made into the skin to make the opening tight enough so that the prolapse does not happen again. The material for encirclement used may range from metals like silver to nylon and silk.
This procedure does not reduce the prolapse but just ensures that it does not become external. It is more like stapling the organ back into its place. The only actual surgery done in this case is removing the redundant tissues off the rectum instead of a part of rectum.
Photo Credit: http://www.thirdage.com/hc/c/rectal-prolapse
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