Rectal Prolapse Treatment In Bangladesh

Diagnosis

The diagnosis of rectal prolapse begins with a physical examination. In the physical examination, the doctor examines the rectum and may insert a lubricated and gloved finger in the anus to check the strength of the anal sphincter muscles and the rectum. Also, the doctor will ask you to describe your medical history and symptoms to understand your condition better. They can even ask you to squat and strain as you do during the bowel movement.

Based on the physical assessment findings, the doctor can ask you for other tests to diagnose the medical condition better. These tests include:

1. Anal electromyography (EMG)– Anal sphincter electromyography (EMG) is recorded using a small sponge electrode in the anal canal. This test measures how effective the muscles and nerves in the rectum are.
2. Anorectal manometry- A flexible, thermometer-sized tube with a small balloon attached to the end is inserted into the rectum. While connected to a machine, this tube is placed in different areas of the rectum, and the response to pressure is estimated. This test helps measure the tightness of the anal sphincter and the functioning of the rectum.
3. Barium enema– A chalky liquid having barium is placed in the rectum during this test. Barium shows up on X-rays producing images of the area.
4. Defecography– It is a radiology test to look inside at the muscles and organs while you defecate. Defecography is used to help determine the cause of constipation, fecal incontinence, and other medical conditions like pelvic organ prolapse that may interfere with a person’s ability to pass stool.
5. Colonoscopy– In this test, a thin, flexible tube with a tiny camera at the end is inserted into the rectum so the doctor can do a visual exam.
6. Transit study– This test demonstrates how well food moves through the colon. The patient swallows one or more capsules containing small markers that are visible on the X-ray. The patient follows a high-fiber diet during this test, and the movement of the markers through the colon is observed with abdominal X-rays taken several times after the capsule is swallowed.
7. Other exams– Your doctor may want to perform other tests to see if there are any weak areas in the pelvic floor or if other organs, like the uterus, have prolapsed.

Surgery

There are two kinds of rectal prolapse surgeries:

• Rectopexy or rectal prolapse repair through the abdomen- In rectopexy, an incision is made in the abdomen, and the surgeon pulls the rectum back in place. Using a mesh sling or sutures, they anchor the rectum to the back wall of the pelvis, known as the sacrum. In some cases, like a long history of constipation, the surgeon removes a portion of the colon.
• Laparoscopic rectal prolapse surgery- Laparoscopic surgery for rectal prolapse is also done through the abdomen through several smaller incisions. The surgeon inserts surgical tools and a tiny camera through the abdominal incisions to repair the rectal prolapse.