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A 63 Female Lady With Chronic Constipation Had A Complete
Question: A 63 female lady with chronic constipation had a complete rectal prolapse 1.5 years a go. The prolapse has been reduced manually through a continuous application of sugar through 2 days. The prolapse has reoccured after 1.5 years and was not been able to be pushed in.The prolapse measured at 10 cm . A manual reduction emergency operation under general anesthesia was performed after which the patient was discharged and asked to take normacol plus as a stool softener. After a day of her taking the Normacol , and with the first bowl movement , the rectal prolapse is completly out again ( That is 2 days after the emergency operation). The exact same thing was done again and an emergency operation was made and patient was discharged after a day of the operation . The Normacol was replaced with Sucralose syrup and bowl movement didn't happen until the seventh day with very minimal amount been moved out. The rectal is still in place .
Doctors have requested MRI defecography along with anal monametry test.
The patient is afraid that during those tests that the prolapse will again been completly out and will undergo an emergency operation for the third time .
Currently , she have the following questions :
1) Through the MR defecogrpayhy and anal monometry , what are the chances of the prolapse is out and again not been able to be pushed in ?
2)What are the dangers of leaving the condition untreated with a surgery ? Is there a chance of gangrene happening while rectal is till in ? Or a chance of it happening if prolapsed for a long period?
3) Is there any non-surgeical remedies she may undergo ?
4)As she had undergone under general anesthesia for two consequtivie time. her legs are swollen but with no pain. Its been reduced over time butstill there. Is that normal?
Doctors have requested MRI defecography along with anal monametry test.
The patient is afraid that during those tests that the prolapse will again been completly out and will undergo an emergency operation for the third time .
Currently , she have the following questions :
1) Through the MR defecogrpayhy and anal monometry , what are the chances of the prolapse is out and again not been able to be pushed in ?
2)What are the dangers of leaving the condition untreated with a surgery ? Is there a chance of gangrene happening while rectal is till in ? Or a chance of it happening if prolapsed for a long period?
3) Is there any non-surgeical remedies she may undergo ?
4)As she had undergone under general anesthesia for two consequtivie time. her legs are swollen but with no pain. Its been reduced over time butstill there. Is that normal?
A 63 female lady with chronic constipation had a complete rectal prolapse 1.5 years a go. The prolapse has been reduced manually through a continuous application of sugar through 2 days. The prolapse has reoccured after 1.5 years and was not been able to be pushed in.The prolapse measured at 10 cm . A manual reduction emergency operation under general anesthesia was performed after which the patient was discharged and asked to take normacol plus as a stool softener. After a day of her taking the Normacol , and with the first bowl movement , the rectal prolapse is completly out again ( That is 2 days after the emergency operation). The exact same thing was done again and an emergency operation was made and patient was discharged after a day of the operation . The Normacol was replaced with Sucralose syrup and bowl movement didn't happen until the seventh day with very minimal amount been moved out. The rectal is still in place .
Doctors have requested MRI defecography along with anal monametry test.
The patient is afraid that during those tests that the prolapse will again been completly out and will undergo an emergency operation for the third time .
Currently , she have the following questions :
1) Through the MR defecogrpayhy and anal monometry , what are the chances of the prolapse is out and again not been able to be pushed in ?
2)What are the dangers of leaving the condition untreated with a surgery ? Is there a chance of gangrene happening while rectal is till in ? Or a chance of it happening if prolapsed for a long period?
3) Is there any non-surgeical remedies she may undergo ?
4)As she had undergone under general anesthesia for two consequtivie time. her legs are swollen but with no pain. Its been reduced over time butstill there. Is that normal?
Doctors have requested MRI defecography along with anal monametry test.
The patient is afraid that during those tests that the prolapse will again been completly out and will undergo an emergency operation for the third time .
Currently , she have the following questions :
1) Through the MR defecogrpayhy and anal monometry , what are the chances of the prolapse is out and again not been able to be pushed in ?
2)What are the dangers of leaving the condition untreated with a surgery ? Is there a chance of gangrene happening while rectal is till in ? Or a chance of it happening if prolapsed for a long period?
3) Is there any non-surgeical remedies she may undergo ?
4)As she had undergone under general anesthesia for two consequtivie time. her legs are swollen but with no pain. Its been reduced over time butstill there. Is that normal?
Brief Answer:
Please go through detailed answer.
Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query sir,
Have seen details of the patient and firstly I am sorry that operation failed two times. That's really painful and sad.
Now let's move to the queries,
Answers are-
1)Both the processes are non invasive/ minimally invasive and requires patient to defecate which the patient has to even if patient is afraid yet defecation is a natural thing and patient has to defecate to live and this is the only requirement of MRI defecography( while patient would pass stools various images would be taken by machine) the same is with manometry while patient is defecating pressure would be measured at various stages. So both the above mentioned tests will have no role in recurrence of rectal prolapse...Patient just needs to defecate normally and that's it. No one can predict the chances it may happen again or not. If operation was successful this time then it won't happen.
2)No at all recommended. Our body is a closed system if any part of the body comes in contact with atmosphere outside there is always a potential risk of infection by bacteria. These bacteria if reaches the blood vessels may called sepsis which may cause septic shock a almost always fatal condition....Secondly risk of gangrene,ulcers etc is always there.
3)No unfortunately surgery is the only option. However as it has failed multiple times a secondary consultation from another surgeon in person is recommended.
4)It is normal and would go away with time once she starts to mobalize and is back to her normal life.
I would strongly recommend a in person(with patient) visit to another surgeon for a second consultation.
Hope I was easy to understand.
Follow ups are welcome.
Go for the tests recommended.
Hope the patient get well soon.
Thank you!
Please go through detailed answer.
Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query sir,
Have seen details of the patient and firstly I am sorry that operation failed two times. That's really painful and sad.
Now let's move to the queries,
Answers are-
1)Both the processes are non invasive/ minimally invasive and requires patient to defecate which the patient has to even if patient is afraid yet defecation is a natural thing and patient has to defecate to live and this is the only requirement of MRI defecography( while patient would pass stools various images would be taken by machine) the same is with manometry while patient is defecating pressure would be measured at various stages. So both the above mentioned tests will have no role in recurrence of rectal prolapse...Patient just needs to defecate normally and that's it. No one can predict the chances it may happen again or not. If operation was successful this time then it won't happen.
2)No at all recommended. Our body is a closed system if any part of the body comes in contact with atmosphere outside there is always a potential risk of infection by bacteria. These bacteria if reaches the blood vessels may called sepsis which may cause septic shock a almost always fatal condition....Secondly risk of gangrene,ulcers etc is always there.
3)No unfortunately surgery is the only option. However as it has failed multiple times a secondary consultation from another surgeon in person is recommended.
4)It is normal and would go away with time once she starts to mobalize and is back to her normal life.
I would strongly recommend a in person(with patient) visit to another surgeon for a second consultation.
Hope I was easy to understand.
Follow ups are welcome.
Go for the tests recommended.
Hope the patient get well soon.
Thank you!
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Please go through detailed answer.
Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query sir,
Have seen details of the patient and firstly I am sorry that operation failed two times. That's really painful and sad.
Now let's move to the queries,
Answers are-
1)Both the processes are non invasive/ minimally invasive and requires patient to defecate which the patient has to even if patient is afraid yet defecation is a natural thing and patient has to defecate to live and this is the only requirement of MRI defecography( while patient would pass stools various images would be taken by machine) the same is with manometry while patient is defecating pressure would be measured at various stages. So both the above mentioned tests will have no role in recurrence of rectal prolapse...Patient just needs to defecate normally and that's it. No one can predict the chances it may happen again or not. If operation was successful this time then it won't happen.
2)No at all recommended. Our body is a closed system if any part of the body comes in contact with atmosphere outside there is always a potential risk of infection by bacteria. These bacteria if reaches the blood vessels may called sepsis which may cause septic shock a almost always fatal condition....Secondly risk of gangrene,ulcers etc is always there.
3)No unfortunately surgery is the only option. However as it has failed multiple times a secondary consultation from another surgeon in person is recommended.
4)It is normal and would go away with time once she starts to mobalize and is back to her normal life.
I would strongly recommend a in person(with patient) visit to another surgeon for a second consultation.
Hope I was easy to understand.
Follow ups are welcome.
Go for the tests recommended.
Hope the patient get well soon.
Thank you!
Please go through detailed answer.
Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query sir,
Have seen details of the patient and firstly I am sorry that operation failed two times. That's really painful and sad.
Now let's move to the queries,
Answers are-
1)Both the processes are non invasive/ minimally invasive and requires patient to defecate which the patient has to even if patient is afraid yet defecation is a natural thing and patient has to defecate to live and this is the only requirement of MRI defecography( while patient would pass stools various images would be taken by machine) the same is with manometry while patient is defecating pressure would be measured at various stages. So both the above mentioned tests will have no role in recurrence of rectal prolapse...Patient just needs to defecate normally and that's it. No one can predict the chances it may happen again or not. If operation was successful this time then it won't happen.
2)No at all recommended. Our body is a closed system if any part of the body comes in contact with atmosphere outside there is always a potential risk of infection by bacteria. These bacteria if reaches the blood vessels may called sepsis which may cause septic shock a almost always fatal condition....Secondly risk of gangrene,ulcers etc is always there.
3)No unfortunately surgery is the only option. However as it has failed multiple times a secondary consultation from another surgeon in person is recommended.
4)It is normal and would go away with time once she starts to mobalize and is back to her normal life.
I would strongly recommend a in person(with patient) visit to another surgeon for a second consultation.
Hope I was easy to understand.
Follow ups are welcome.
Go for the tests recommended.
Hope the patient get well soon.
Thank you!
Above answer was peer-reviewed by :
Dr. Kampana
Thanks for the response.
Now,
1) If she refused to do the required tests and decided not to do the surgery , what are the consequences. She wants to understand the importance of the tests as the surgeons are not really keen to explain. She is already diagnosed with the total prolapse , so why would they make the tests ?
2) As for the surgery , it wasn't a real surgery rather than an emergency operation where they try to keep it back inside. Do you think that this operation if done correctly would result in a rectal that doesn't prolapse again ?
3) If decided for the surgery , what would be the way it is done and how well she can return to her normal lif eactivities after been operated? Is is a big surgery with a high risks or not?
Now,
1) If she refused to do the required tests and decided not to do the surgery , what are the consequences. She wants to understand the importance of the tests as the surgeons are not really keen to explain. She is already diagnosed with the total prolapse , so why would they make the tests ?
2) As for the surgery , it wasn't a real surgery rather than an emergency operation where they try to keep it back inside. Do you think that this operation if done correctly would result in a rectal that doesn't prolapse again ?
3) If decided for the surgery , what would be the way it is done and how well she can return to her normal lif eactivities after been operated? Is is a big surgery with a high risks or not?
Thanks for the response.
Now,
1) If she refused to do the required tests and decided not to do the surgery , what are the consequences. She wants to understand the importance of the tests as the surgeons are not really keen to explain. She is already diagnosed with the total prolapse , so why would they make the tests ?
2) As for the surgery , it wasn't a real surgery rather than an emergency operation where they try to keep it back inside. Do you think that this operation if done correctly would result in a rectal that doesn't prolapse again ?
3) If decided for the surgery , what would be the way it is done and how well she can return to her normal lif eactivities after been operated? Is is a big surgery with a high risks or not?
Now,
1) If she refused to do the required tests and decided not to do the surgery , what are the consequences. She wants to understand the importance of the tests as the surgeons are not really keen to explain. She is already diagnosed with the total prolapse , so why would they make the tests ?
2) As for the surgery , it wasn't a real surgery rather than an emergency operation where they try to keep it back inside. Do you think that this operation if done correctly would result in a rectal that doesn't prolapse again ?
3) If decided for the surgery , what would be the way it is done and how well she can return to her normal lif eactivities after been operated? Is is a big surgery with a high risks or not?
Brief Answer:
Follow up.
Detailed Answer:
Hi there and thank you for follow up,
1) Please explain to her that previously the surgery has failed for 3 times in past so its very important to know if there is some thing wrong with the pressures created at the time of defecating or there is some anatomical problem with that area.Hope you can understand that suture is used every time but some how the suture are broken and rectum prolapses again, In such situation its essential to know that what is happening at the time patient is defecating and all she needs to do for the test is to defecate(which she has to;Its natural).
Yes she is diagnosed with rectal prolapse and its not a new disease there are millions of patients having rectal prolapse and are fully cured post surgical correction.Now why surgery is failing in her case( to know it tests are required).If she won't go for the test chances of failure are high,Though no one can predict whats going to happen.But tests suggested by doctor are genuine.
2)For answering this query in need to know the complete details of procedure done on patient.Hope they have provided those details and surgery notes with discharge sheets.Kindly attach.
In many countries patient presents in emergency from where a call is given to specialist who performs surgery.So in my country its common. The procedure was performed under general anesthesia i don't think its just a manual reduction.However exact and professional answer could be given only after going through operative notes of patient.
In short you have to ask doctor if rectoplexy has been performed or not.
3)The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is.
So again its the call which treating surgeon would take however most commonly laproscopic rectoplexy is performed.
But whether to go via abdomen(incision) or through laproscope;The final call has to be taken by operating doctor.
Every surgery performed under general anesthesia is a big surgery however frankly this is a common surgery and if done properly usually complications are not there.
She would return back to completely normal life 4-6 weeks post surgery.
Hope i was helpful,
Follow ups are welcome,
Thank you!
Follow up.
Detailed Answer:
Hi there and thank you for follow up,
1) Please explain to her that previously the surgery has failed for 3 times in past so its very important to know if there is some thing wrong with the pressures created at the time of defecating or there is some anatomical problem with that area.Hope you can understand that suture is used every time but some how the suture are broken and rectum prolapses again, In such situation its essential to know that what is happening at the time patient is defecating and all she needs to do for the test is to defecate(which she has to;Its natural).
Yes she is diagnosed with rectal prolapse and its not a new disease there are millions of patients having rectal prolapse and are fully cured post surgical correction.Now why surgery is failing in her case( to know it tests are required).If she won't go for the test chances of failure are high,Though no one can predict whats going to happen.But tests suggested by doctor are genuine.
2)For answering this query in need to know the complete details of procedure done on patient.Hope they have provided those details and surgery notes with discharge sheets.Kindly attach.
In many countries patient presents in emergency from where a call is given to specialist who performs surgery.So in my country its common. The procedure was performed under general anesthesia i don't think its just a manual reduction.However exact and professional answer could be given only after going through operative notes of patient.
In short you have to ask doctor if rectoplexy has been performed or not.
3)The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is.
So again its the call which treating surgeon would take however most commonly laproscopic rectoplexy is performed.
But whether to go via abdomen(incision) or through laproscope;The final call has to be taken by operating doctor.
Every surgery performed under general anesthesia is a big surgery however frankly this is a common surgery and if done properly usually complications are not there.
She would return back to completely normal life 4-6 weeks post surgery.
Hope i was helpful,
Follow ups are welcome,
Thank you!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Follow up.
Detailed Answer:
Hi there and thank you for follow up,
1) Please explain to her that previously the surgery has failed for 3 times in past so its very important to know if there is some thing wrong with the pressures created at the time of defecating or there is some anatomical problem with that area.Hope you can understand that suture is used every time but some how the suture are broken and rectum prolapses again, In such situation its essential to know that what is happening at the time patient is defecating and all she needs to do for the test is to defecate(which she has to;Its natural).
Yes she is diagnosed with rectal prolapse and its not a new disease there are millions of patients having rectal prolapse and are fully cured post surgical correction.Now why surgery is failing in her case( to know it tests are required).If she won't go for the test chances of failure are high,Though no one can predict whats going to happen.But tests suggested by doctor are genuine.
2)For answering this query in need to know the complete details of procedure done on patient.Hope they have provided those details and surgery notes with discharge sheets.Kindly attach.
In many countries patient presents in emergency from where a call is given to specialist who performs surgery.So in my country its common. The procedure was performed under general anesthesia i don't think its just a manual reduction.However exact and professional answer could be given only after going through operative notes of patient.
In short you have to ask doctor if rectoplexy has been performed or not.
3)The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is.
So again its the call which treating surgeon would take however most commonly laproscopic rectoplexy is performed.
But whether to go via abdomen(incision) or through laproscope;The final call has to be taken by operating doctor.
Every surgery performed under general anesthesia is a big surgery however frankly this is a common surgery and if done properly usually complications are not there.
She would return back to completely normal life 4-6 weeks post surgery.
Hope i was helpful,
Follow ups are welcome,
Thank you!
Follow up.
Detailed Answer:
Hi there and thank you for follow up,
1) Please explain to her that previously the surgery has failed for 3 times in past so its very important to know if there is some thing wrong with the pressures created at the time of defecating or there is some anatomical problem with that area.Hope you can understand that suture is used every time but some how the suture are broken and rectum prolapses again, In such situation its essential to know that what is happening at the time patient is defecating and all she needs to do for the test is to defecate(which she has to;Its natural).
Yes she is diagnosed with rectal prolapse and its not a new disease there are millions of patients having rectal prolapse and are fully cured post surgical correction.Now why surgery is failing in her case( to know it tests are required).If she won't go for the test chances of failure are high,Though no one can predict whats going to happen.But tests suggested by doctor are genuine.
2)For answering this query in need to know the complete details of procedure done on patient.Hope they have provided those details and surgery notes with discharge sheets.Kindly attach.
In many countries patient presents in emergency from where a call is given to specialist who performs surgery.So in my country its common. The procedure was performed under general anesthesia i don't think its just a manual reduction.However exact and professional answer could be given only after going through operative notes of patient.
In short you have to ask doctor if rectoplexy has been performed or not.
3)The kind of surgery your doctor recommends will depend on factors such as your overall health, age, and how serious your condition is.
So again its the call which treating surgeon would take however most commonly laproscopic rectoplexy is performed.
But whether to go via abdomen(incision) or through laproscope;The final call has to be taken by operating doctor.
Every surgery performed under general anesthesia is a big surgery however frankly this is a common surgery and if done properly usually complications are not there.
She would return back to completely normal life 4-6 weeks post surgery.
Hope i was helpful,
Follow ups are welcome,
Thank you!
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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