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In the operating room, the rectum is made to intentionally prolapse outside the body and is then divided. While this is very unusual, it should be considered when making decisions about the type of surgery to perform. Overall, rectal prolapse affects relatively few people 2. While this may be somewhat embarrassing for patients, it is very important to make an accurate diagnosis, as the treatments of hemorrhoids and rectal prolapse are very different. Regardless of the specific technique used, the intent is to hold the rectum in the appropriate position until such a time as scarring occurs to fix the rectum in place.
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The pudendal nerve contributes to the control of the anal sphincter and damage can result from direct trauma birthing injury , chronic diseases such as diabetes, and from back injury or surgery. These advantages have, until recently, been considered to be offset by a higher recurrence rate. Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum, and anus. Fecal incontinence can be a bigger problem following this procedure compared to an abdominal rectopexy, though most patients have had pre-existing incontinence. Rectal Prolapse Expanded Version. Importantly, if these additional issues are not addressed at the time of fixing the rectal prolapse, the symptoms related to these other problems may worsen. This is called monitored anesthesia with a perianal block.
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Before considering surgery, a careful history and physical examination should be done. The amount of colon removed is determined by the severity of constipation and may involve the use of the previously described colonic transit study. Sexual dysfunction may be reported in some patients following the extensive pelvic dissection involved in this surgery. It is generally believed that the perineal approach results in fewer complications and pain, with a reduced length of hospital stay. Rectal prolapse may be confused with significant hemorrhoid disease and can even be confusing at times to physicians not frequently evaluating and treating this problem. A rectopexy is then performed, whereby the rectum is pulled upwards and secured to the sacrum back wall of the pelvis in a variety of ways. Pelvic nerve damage pudendal nerve has been shown in many patients with prolapse.
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