Doctors for Rectal Prolapse in Kochi

Rectal prolapse is a medical condition characterized by the displacement of the rectum, which is the lower part of the large intestine, causing it to protrude or fall out of the anus. It occurs when the supporting tissues and muscles of the rectum weaken or stretch, causing the rectal walls to lose their ability to stay inside the body. Rectal prolapse can be categorized into three types: partial or mucosal prolapse, complete prolapse, and internal prolapse. In partial prolapse, only the lining of the rectum extends outside the anus. Complete prolapse refers to a condition where the full thickness of the rectal wall protrudes, typically appearing as a reddish mass. Internal prolapse, on the other hand, occurs when the rectum folds onto itself internally without protruding outward. While rectal prolapse is more commonly observed in elderly individuals, particularly women, it can occur at any age.

The treatment approach for rectal prolapse is determined by factors such as the severity of the condition, the patient's age, overall health, and their personal preferences. Here are some common treatment options for rectal prolapse:

• Non-surgical interventions: In some cases, non-surgical methods may be recommended to manage rectal prolapse. These include dietary modifications to prevent constipation and straining, pelvic floor exercises to strengthen the muscles, and the use of stool softeners or laxatives to promote regular bowel movements.
• Manual reduction: For patients with a partial or mild rectal prolapse, a healthcare professional may manually push the rectum back into place. This procedure, called manual reduction, is usually performed under anesthesia.
• Surgical procedures: Surgery is often required for complete rectal prolapse or cases where non-surgical treatments have been ineffective. There are several surgical options available, including:
1. Rectopexy: This procedure involves surgically securing the rectum to the surrounding tissues to prevent it from prolapsing. Rectal prolapse can be treated through open surgery or minimally invasive techniques like laparoscopy or robotic-assisted surgery. The choice of method depends on factors specific to the patient and is determined by the surgeon.
2. Delorme's procedure: Also known as a rectosigmoidectomy, this surgery involves removing a portion of the rectal lining and then folding and suturing the remaining rectal tissue to reduce the prolapse.
3. Altemeier procedure: This surgery is performed to treat rectal prolapse in elderly or high-risk patients. Rectal prolapse surgery typically involves the removal of the prolapsed rectal tissue followed by the closure of the rectal wall.
4. Perineal proctectomy: In this procedure, the rectum is removed through an incision made in the perineal area (between the anus and the genitals). It is commonly used for older patients or those with significant medical comorbidities.
• Biofeedback therapy: This approach involves training the pelvic floor muscles and improving bowel function through biofeedback techniques.It can be utilized as a supplementary therapy to enhance muscle strength and coordination.

The choice of treatment depends on various factors, and it is important to consult with a healthcare professional to determine the most appropriate approach for each individual case of rectal prolapse.

Rectal prolapse may require surgery in the following situations:

• Complete or severe prolapse: If the rectal prolapse is extensive, involving the full thickness of the rectal wall and causing significant discomfort or functional impairment, surgery is often recommended.
• Failed non-surgical treatments: If non-surgical interventions such as dietary modifications, pelvic floor exercises, and medications have not provided sufficient relief or the prolapse keeps recurring, surgery may be considered.
• Presence of complications: Rectal prolapse can lead to complications such as chronic bleeding, ulceration, or incarceration (inability to reduce the prolapse back into the body). In some cases, surgery may be required to address these complications and prevent further discomfort or damage.
• Patient preference: In cases where the rectal prolapse significantly affects a person's quality of life, causing pain, discomfort, or embarrassment, surgery may be chosen as a preferred treatment option.

It is important to consult with a healthcare professional who can evaluate the severity of the prolapse, assess individual circumstances, and discuss the potential benefits and risks of surgery. The decision regarding surgery should be individualized, considering factors such as the patient's overall health, age, and personal preferences.

Before undergoing rectal prolapse surgery in Kochi or any other location, the following diagnostic tests and evaluations may be performed:

• Medical history and physical examination: Your doctor will review your medical history, including any symptoms you have experienced and previous treatments. They will also conduct a physical examination, including a rectal examination, to assess the extent and severity of the prolapse.
• Imaging tests: Various imaging tests may be recommended to evaluate the rectal prolapse and surrounding structures. These can include:
1. Barium enema or defecography: Barium enema or defecography is a diagnostic test that entails the introduction of a contrast material into the rectum, followed by imaging of the area during bowel movements. It helps identify abnormalities in the rectum and assess its function.
2. Colonoscopy: Colonoscopy is a procedure that utilizes a flexible tube equipped with a camera to examine the rectum and colon. It can help rule out other underlying conditions that may contribute to the rectal prolapse.
3. Endorectal ultrasound: Endorectal ultrasound is a diagnostic test that employs sound waves to generate images of the rectum and anal sphincter muscles. It offers detailed information about the anatomy and condition of the rectal tissues.
• Anorectal manometry: Anorectal manometry is a diagnostic test that assesses the pressure and function of the rectum and anal sphincter muscles. It can help evaluate the muscle strength and coordination, which may be relevant in surgical planning.
• Preoperative assessment: As part of the preoperative assessment, a thorough evaluation is conducted, which may involve blood tests, electrocardiogram (ECG), and other investigations. These assessments aim to evaluate the patient's overall health, identify any potential risks, and uncover underlying conditions before the surgery.

The specific diagnostic tests and evaluations may vary depending on the individual case and the recommendations of the treating surgeon. It is important to consult with a qualified healthcare professional in Kochi who specializes in colorectal surgery to determine the appropriate diagnostic approach before rectal prolapse surgery.

The surgical procedure may vary depending on the severity and type of rectal prolapse, but the general steps involved in rectal prolapse surgery are as follows:

• Anesthesia : The surgery is performed under general anesthesia, which means you will be asleep and won't feel any pain during the procedure.
• Incision : The surgeon makes an incision in the abdomen or the perineum (the area between the anus and the genitals). The choice of incision depends on the specific technique used and the surgeon's preference.
• Rectal Resection (if needed) : In some cases, if there is a significant amount of rectal tissue that is damaged or weakened, the surgeon may perform a rectal resection. This involves removing a portion of the rectum to create a healthier and more stable rectal segment.
• Rectopexy : The main part of the procedure involves restoring the rectum to its normal position and securing it in place. The surgeon may use different techniques for rectopexy, including:
• Open Technique: The surgeon manually lifts the prolapsed rectum back into its proper position and then attaches it to the surrounding tissues using sutures or a mesh. This helps provide support and prevents future prolapse.
• Laparoscopic Technique : Instead of making a large incision, several small incisions are made in the abdomen. The surgeon inserts a laparoscope (a thin, flexible tube with a camera) and specialized surgical instruments through these incisions to perform the rectopexy. This technique offers advantages such as smaller incisions, reduced pain, and faster recovery.
• Closure and Recovery: Once the rectum is secured in its proper position, the incisions are closed with sutures or staples. The surgical site is then dressed, and you will be taken to the recovery room.

After the surgery, you will be monitored closely by medical professionals to ensure your vital signs are stable. Pain medications will be provided to manage any discomfort. The length of hospital stay can vary, ranging from a day or two to several days, depending on the specific case and the individual's recovery progress.

Rectal prolapse surgery in Kochi, like any other location, offers several benefits for individuals suffering from rectal prolapse. Here are some potential benefits of undergoing rectal prolapse surgery in Kochi:

• Resolution of Symptoms : Rectal prolapse can cause a range of uncomfortable and bothersome symptoms, including the protrusion of the rectum through the anus, difficulty with bowel movements, fecal incontinence, and a constant feeling of incomplete bowel emptying. Rectal prolapse surgery aims to correct the prolapse and restore the rectum to its normal position, alleviating these symptoms and improving bowel function.
• Improved Quality of Life : Rectal prolapse can significantly impact a person's daily life and quality of life. It can limit physical activities, interfere with work or social engagements, and cause embarrassment or discomfort. By addressing the prolapse through surgery, individuals can experience a significant improvement in their quality of life. They can resume normal activities, regain confidence, and have better control over their bowel movements.
• Prevention of Complications : Rectal prolapse can lead to complications such as ulceration, bleeding, infection, and incarceration (when the prolapsed rectum becomes trapped outside the body and cannot be easily pushed back in). Surgery helps prevent these complications by correcting the prolapse and eliminating the risk of further damage or infection to the prolapsed rectum.
• Long-term Durability : Rectal prolapse surgery, when performed by an experienced surgeon, can provide long-term durability. The surgery aims to restore the rectum to its anatomically correct position and secure it in place, reducing the likelihood of future prolapse episodes. This durability allows individuals to have sustained relief from symptoms and a reduced risk of recurrence.
• Improved Bowel Function: Rectal prolapse can disrupt normal bowel function, leading to difficulty with bowel movements, incomplete evacuation, and fecal incontinence. Rectal prolapse surgery helps restore normal bowel function by repositioning the rectum and improving its support. This can result in better bowel control, more regular bowel movements, and a decreased reliance on laxatives or other medications.
• Enhanced Psychological Well-being : Rectal prolapse can have a significant psychological impact on individuals, causing embarrassment, anxiety, and a negative self-image. By successfully treating the prolapse through surgery, individuals often experience an improvement in their psychological well-being. They can regain confidence, feel more comfortable in social situations, and overcome the emotional burdens associated with rectal prolapse.

Rectal prolapse surgery, like any surgical procedure, carries potential side effects and risks that can vary depending on the surgical technique employed and individual factors. Here are some common side effects and risks associated with rectal prolapse surgery:

• Pain and discomfort: After surgery, it is common to experience pain and discomfort at the incision site or in the rectal area. Pain medications prescribed by your surgeon can effectively manage post-operative discomfort.
• Infection: There is a possibility of developing an infection at the surgical site, which is a potential risk associated with rectal prolapse surgery. The surgical team takes precautions to minimize this risk, such as using sterile techniques during the procedure and prescribing antibiotics when necessary.
• Bleeding: Some bleeding is normal after surgery, but excessive bleeding may occur in rare cases. Your surgeon will monitor you closely for any signs of abnormal bleeding.
• Urinary problems: There is a small risk of temporary urinary difficulties, such as difficulty passing urine or urinary retention, following rectal prolapse surgery. This can be managed with medications or temporary catheterization if necessary.
• Bowel function changes: Following rectal prolapse surgery, some individuals may experience changes in bowel function, such as temporary or permanent changes in bowel movements, frequency, or consistency. These changes are usually manageable and improve over time.
• Recurrence: In some cases, rectal prolapse may recur even after surgery.The risk of recurrence after rectal prolapse surgery is influenced by multiple factors, including the underlying condition and the specific surgical technique employed.
• Anesthetic risks: The use of anesthesia during surgery carries its own risks, including allergic reactions, adverse reactions to medications, and breathing difficulties.The risks associated with rectal prolapse surgery are typically minimal, and they will be closely monitored by the anesthesia team.
• Complications specific to the surgical technique: Different surgical techniques carry their own specific risks and complications. Your surgeon will provide detailed information and discuss these risks with you prior to the rectal prolapse surgery.

Prior to undergoing rectal prolapse surgery, it is crucial to have a discussion with your surgeon regarding potential side effects and risks associated with the procedure. They will provide you with detailed information about the specific risks associated with your procedure and address any concerns you may have.

Recovery after rectal prolapse treatment, whether surgical or non-surgical, requires proper care and adherence to post-operative instructions. Here are some general guidelines for recovery after rectal prolapse treatment:

• Hospital stay: The length of the hospital stay depends on the specific procedure performed and individual factors. It can range from a few hours for some minimally invasive surgeries to a few days for more extensive procedures. Your healthcare team will closely monitor your condition and ensure that you are medically stable and ready for discharge before you are sent home after rectal prolapse surgery.
• Pain management: You may experience discomfort or pain after rectal prolapse treatment. To manage post-operative pain, your doctor will provide you with prescribed pain medications. It is important to take the medications as directed and report any severe or prolonged pain to your healthcare team.
• Wound care: If you have an incision, you will need to keep the area clean and dry. It is important to adhere to the instructions provided by your surgeon regarding wound care, dressing changes, and bathing after rectal prolapse surgery.
• Diet and hydration: Your doctor will provide specific dietary instructions to promote healing and prevent complications. This may include gradually reintroducing solid foods, staying hydrated, and avoiding foods that can cause constipation or straining.
• Activity and rest: Initially, you may need to limit physical activities and avoid heavy lifting or strenuous exercises. Gradually, you can increase your activity level as guided by your surgeon. However, it is essential to listen to your body and not overexert yourself during the recovery period.
• Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare team. Your healthcare team will closely monitor your progress, remove any sutures as needed, and address any concerns or complications that may arise during your recovery from rectal prolapse surgery.

The recovery time for rectal prolapse treatment can vary depending on factors such as the type of treatment, overall health of the individual, and the extent of the prolapse. Typically, the recovery period ranges from a few weeks to a few months. Minimally invasive procedures often have shorter recovery times compared to open surgeries. Your surgeon will offer a more precise estimate of the anticipated recovery time based on your specific situation and the type of rectal prolapse treatment you undergo.