Let's learn about Rectal Prolapse and Surgery (Rectopexy)

Do you sometimes feel a heaviness in your anus after going to the toilet, or as if something has come out? Although this is a somewhat embarrassing and embarrassing topic to talk about, it can actually be a health problem that affects many people to some extent. We call this condition 'Rectal Prolapse'. So, there is nothing to be afraid of or ashamed of. Let's talk about it openly.

What is Rectal Prolapse?

Simply put, this is when the last part of your large intestine, the part that connects to your rectum, slips out through your anus. Think of it like the parts of a telescope sliding in and out. This can happen as you get older, during pregnancy or after giving birth, or as a result of an accident or illness.

Who is more likely to experience this condition?

This is not very common. It affects a small percentage of the population, about 0.5%, and can affect anyone of any age, but it is more common in women over the age of 50 .

When adults develop this condition, it cannot be cured without surgery. However, when it occurs in young children, the situation is a little different. In children, it usually develops due to things like persistent constipation, diarrhea, or parasitic infections. When the underlying cause is properly treated, the muscles that hold the rectum in place strengthen again and the condition heals. Therefore , children rarely need surgery for this .

What are the types of surgery (Rectopexy) available?

There are two main types of surgery to correct rectal prolapse. Your doctor will choose the most appropriate procedure for you based on your overall health and the extent of your rectal prolapse.

Abdominal Procedures

These surgeries are always performed under general anesthesia .

• Open surgery (Abdominal rectopexy): The doctor makes an incision in your abdomen, pulls back the protruding part of the intestine, and secures it to the back wall of the pelvis with permanent stitches. Sometimes, a mesh may be used.
• Laparoscopic rectopexy: This surgery is performed by making just a few small incisions in the abdomen and inserting a thin tube with a camera (laparoscope) and instruments through them.
• Robotic rectopexy: This is similar to laparoscopic surgery, but the doctor performs the surgery with the help of a robot.

Sometimes, if you have severe constipation, a colectomy (removal of part of the intestine) may be performed at the same time as this surgery.

Perineal Procedures

These surgeries can be performed under general anesthesia or with an epidural.

• Altemeier procedure: In this procedure, the protruding part of the intestine is pulled out of the anus, cut out, and removed. The two remaining parts of the intestine are then stitched together.
• Delorme's procedure: This is done for small protrusions. Here, only the lining of the intestine is removed, the muscle layer is folded, and the lining is sewn back inside the rectum. This thickening prevents the intestine from coming out due to the wall.

What are the benefits and possible complications of surgery?

If an adult develops this condition, surgery is the only solution. If surgery is not performed, the following can occur:

• Severe constipation
• Fecal incontinence
• The part of the intestine that has come out becomes stuck, blood flow stops and that part dies (Gangrene)
• Rectal ulcers and resulting anemia

Like any surgery, there are risks. For example, bleeding, blood clots, and scarring. Although abdominal surgery carries a slightly higher risk, the risk of recurrence is lower .

Specific complications that may occur after surgery are:

• Abnormal formation of tubes around the anus (Anal fistulas)
• Anastomotic leak
• Bowel obstruction
• Sexual dysfunction
• Constipation increases further

How long does it take to recover and what should I do after the surgery?

After surgery, you will need to stay in the hospital for a few days or a week. It may take several weeks to get back to normal after you go home. It may even take several months for your bowel movements to return to normal.

During recovery, you should take special care of these things:

• Prevent constipation: Eat plenty of fiber-rich foods (vegetables, fruits, and legumes). Drink plenty of water throughout the day.
• Don't strain when going to the toilet: This is very important. Straining can cause the problem to recur.
• Stool softeners: If prescribed by your doctor, use them exactly as prescribed.

When do you want to see the doctor again?

If you experience these symptoms after surgery, you should call your doctor immediately .

• If you are bleeding more than normal.
• If severe constipation recurs.
• If you notice signs that the anus is protruding again .
• If you see signs of infection, such as fever, redness, and swelling at the surgical site .

Many people delay seeking treatment because of the shame and embarrassment of talking about these things. But remember, this is not something that will get better without treatment. It will only get worse over time. Therefore, if you have these symptoms, speaking to a doctor without fear and getting the necessary treatment will help improve your quality of life greatly.

Rectal Prolapse, Rectopexy, Surgery, Constipation, Anus, Bowel, Surgery