Rectopexy

Often people face problems that are difficult to talk about out loud. One of these is rectal prolapse. To help with this delicate problem, doctors use rectopexy, a surgical operation. What is this operation and how to prepare for it? What consequences or complications can arise after it? Is it possible to get rid of such a problem with conservative methods? The answers to these and many other questions can be found by reading the proposed article.

Causes and symptoms of rectal prolapse

This problem occurs in both adults and children and it is associated with various factors. It occurs when the wall of the rectum protrudes through the anus. This disease brings incredible discomfort, therefore, when the first symptoms appear, it requires immediate contact with a specialist proctologist.

Often, the onset of the disease can be judged by some symptoms that are its harbingers and become an obligatory reason for visiting a doctor. First of all, it can be chronic constipation or any other problems that cause constant discomfort during bowel movements. Often they torment patients from a very young age.

Sometimes harbingers of rectal prolapse are frequent pulling pains in the lower abdomen in the pelvic region, as well as constant excretion of feces on underwear.

With this disease, certain difficulties associated with incontinence of liquid feces or gases are characteristic. Later, during the act of defecation, the protrusion of the rectum from the anus is noticeably manifested, over time, this problem appears more and more often and occurs even when coughing or walking, giving the patient both physical inconvenience and emotional discomfort.

In the mild initial stages of the disease, the reduction of the intestine occurs spontaneously, at the later stages of its progression, the patient independently sets the rectum into the anus with his hand, since by itself it no longer returns to its place. At the same time, the patient constantly feels physical discomfort: constant moistening in the anus, secretion of mucus and blood from the anus, accompanied by regular severe itching.

There are a lot of reasons that could provoke the occurrence and development of this disease. Here are the most common ones:

• frequent constipation, in which the patient is constantly pushing;
• injury to the muscles of the anus during severe delivery, which led to multiple tears in the perineum;
• age-related changes, which are characterized by a noticeable weakening of the muscles and ligaments of the anus;
• surgical interventions performed on the rectum or on the internal organs of the small pelvis.

Diagnosis and treatment of the disease

The diagnosis of this disease is carried out by a proctologist, while prescribing a comprehensive examination. Most often, an experienced specialist can make a correct diagnosis already during the initial examination: when straining with the naked eye, a protruding part of the rectum is observed, and during palpation it is possible to assess the condition of its walls.

For diagnostic purposes, colonoscopy is often prescribed, as well as sigmoidoscopy, to exclude the possible presence of polyps.

In women, this disease is often accompanied by solitary ulcer syndrome and perineal prolapse, which leads to uterine prolapse and urinary incontinence. Therefore, treatment in such cases should be carried out with the involvement of a gynecologist.

With concomitant peptic ulcer disease, the doctor determines treatment priorities based on the individual characteristics and severity of each disease. If the most priority at the moment is the problem of prolapse of the intestine, then first of all the treatment is aimed at its correction and reduction, and the ulcer in this case is treated with medications. In some cases, cryotherapy or photocoagulation may be prescribed.

In children, rectal prolapse is recommended to be treated with conservative methods and changes in diet and lifestyle. It is necessary to teach the child to go to the toilet at the same time, to observe the hygiene of the anus. It is necessary to enrich his food with vegetable fiber, nutrients and vitamins. In this case, physiotherapy and physiotherapy exercises aimed at strengthening the muscles of the pelvis and anus will be useful.

In adults, conservative methods are used to treat such a disease, but they do not give a XNUMX% guarantee of getting rid of the problem. The most effective and progressive method of surgical treatment is currently considered to avoid recurrence of the disease and get rid of such a delicate problem forever. This operation is called presacral rectopexy.

Rectopexy, its features, the course of the operation and possible complications

A rectopexy is an elective surgery to strengthen the muscles and ligaments of the anus, which helps keep the rectum in the pelvic area. It is a mobilization of the rectum with its fixation using a collagen or synthetic mesh. It is usually performed laparoscopically. It is often used after unsuccessful perineal operations, and also when, with the abdominal variant, there is a risk of impaired blood supply to the colon.

Such an operation is carried out in a hospital in a sterile operating room.

Indications for rectopexy are:

• prolapse of the rectum;
• possible relapses of prolapse of the intestine, including after operations with perineal access.

Preparation for such an operation includes:

• comprehensive examination of the patient;
• examination of the rectum;
• antibiotic prophylaxis;
• obligatory complete lavage of the colon.

During the operation, the doctor cuts the abdominal cavity on the right and left in the direction of the pelvic region. After that, in women during laparoscopic surgery, the uterus is fixed to the anterior abdominal wall. Then a mesh, six to ten centimeters in size, is implanted into the abdominal cavity. To do this, it is rolled up into a tube, pushed inward and unfolded. The mesh is placed behind the rectum and fixed with a suture. After it is wrapped around the intestine and the edges are sewn up with three or four sutures.

The final stage of the operation is the removal of the suture from the uterus, drainage and suturing of the incisions.

This operation has no age restrictions, so it is also used to treat elderly patients. In addition, modern options for anesthesia allow operations for rectal prolapse in patients of any age.

Possible complications during such an intervention are: bleeding, recurrence of intestinal prolapse, erosion or infectious processes caused by mesh dislocation, damage to the ureter.

In conclusion

Rectopexy is a laparoscopic elective operation that strengthens the ligaments and muscles of the anus, which allows you to forget about such a problem as a prolapse of the rectum from the anus forever. This is a very effective and progressive technique that excludes possible relapses and has no age restrictions. It can be performed on both young and old patients. But before deciding on any treatment, it is necessary to consult with a proctologist and undergo the necessary examination to exclude the possibility of other diseases.