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Rectal Prolapse Surgery

Providing Compassionate Treatment & Surgery for Rectal Prolapse

Dr Naseem Mirbagheri is an Australian qualified surgeon based in Melbourne, and one of only women specialising in colorectal and pelvic floor surgeries. As well as 14 years spent training as a surgeon at hospitals around Victoria, Dr Naseem also holds a PhD in faecal incontinence and Sacral Nerve Stimulation from the University of Sydney and is experienced in both laparoscopic and open surgery.

Dr Naseem provides expert surgical consultations, and is dedicated to providing compassionate and effective treatment for pelvic floor procedures including rectal prolapse surgery, at a number of public and private hospitals in Victoria, including:

  • Royal Women’s Hospital (public)
  • St John of God Berwick (private)
  • Epworth Richmond (private)
  • Box Hill Hospital (public)
  • Wonthaggi Hospital (public)

 

What is rectal prolapse?

A rectal prolapse refers to the protrusion of the rectum, which is the lower most part of the large bowel, through and outside the anus. This happens when the normal attachments that keep the rectum fixed are lost allowing the rectum to slide out.

There are various degrees of prolapse: internal, where the rectum does not come outside the anal canal, and external, where the whole rectum is pushed out.

Cause and symptoms

The exact cause of rectal prolapse is unknown but it is commonly seen in women aged 50 or above. Common associations apart from gender and age include straining on toilet, chronic constipation, vaginal delivery or weak pelvic floor muscles. The link to vaginal delivery is not absolute, as nulliparous women and men also suffer from this condition.

Most people present with a lump that comes out at time of defaecation and usually goes back in by itself or may require manual reduction. Not everyone will experience a lump, secondary symptoms such as mucous discharge, faecal incontinence, feeling of heaviness or dragging and bleeding maybe present. The prolapsing rectum can significantly adversely impact on the continence mechanism.

Diagnosis and treatment  

It is important to rule out sinister cause, as in rare cases a tumour in the rectum can cause a prolapse and Dr Naseem might consider organising a colonoscopy for you in the first instance.

In patients in whom the diagnosis is not clear, a radiological study known as the defaecatory proctogram is done. This diagnostic test involves taking radiological pictures of a simulated defaecation to confirm the protrusion of the rectum. Dr Naseem often performs an EUA (Examination Under Anaesthetics) to confirm the presence of rectal prolapse, this is usually done in conjunction with colonoscopy. In this procedure a forcep is used to drag the rectum out to be assessed.

Management of rectal prolapse is usually surgical; once prolapse occurs, it is not possible to correct the protrusion even if you stop straining on the toilet. There are over 100 surgical procedures described for repair of rectal prolapse, a testament to the difficulty in treating this condition and high rates of recurrence post repair.

The surgery usually involves reduction of the prolapse and some cases resection of the bowel and fixation of the rectum in the pelvis. This operation can be performed laparoscopically, robotically or transperineally (i.e. via the anal canal).

Some of the most commonly performed surgical repairs include laparoscopic ventral mesh rectopexy and Delormes procedure. Laparoscopic mesh rectopexy is a key hole procedure which involves pulling up the rectum and fixing in place with the use of mesh in the pelvis. A delormes procedure involves suturing the rectal muscle whilst removing it inner lining. It is important to address underlying cause of prolapse such as straining and constipation to reduce risk of recurrence. Dr Naseem is highly skilled in performing surgeries for rectal prolapse and will tailor the correct surgery for the right patient.

Dr Naseem is happy to answer any questions you may have about pelvic floor procedures such as rectal prolapse surgery, and will be happy to provide you with clear, easy-to-read information to address any concerns or enquiries about the surgical procedures you may be considering.

 

How to book a surgery consultation with Dr Naseem

If you would like to speak to Dr Naseem about performing your rectal prolapse surgery, she is available for surgical consultation at her offices in Richmond and Berwick. Just call 1300 79 50 90 or send us a scanned copy of your referral letter via our online referral page, and we will be sure to get back to you within 24 hours to arrange a time.