Causes

Congenital, acquired, poor bowel habit or straining at micturition, neurological (cauda equine, spinal cord injury, spina bifida), female gender (especially so after hysterectomy), redundant rectosigmoid and/or deep pouch of Douglas, defect in pelvic floor, previous surgery (piles surgery, fistulotomy)

Symptoms

Something prolapsing out of the anus (during straining, coughing, lifting weights), constipation (in 58%), fecal incontinence, mucus discharge, and in rare cases bleeding (when massive or irreducible)

Diagnostics

Defecogram or Dynamic MRI, Anal manometry, EUS (only useful in pelvic floor trauma), colon transit time, sigmoidoscopy (to exclude other causes)

Treatment

• Laparoscopic rectopexy (fixation) with or without sigmoid/ bowel resection is the preferred treatment.
• Only in elderly or young males an anal (perineal) approach is being used, which has a higher prolapse recurrence rate (30% versus 5%), but is a lower risk operation and preserves sexual function better.
• A non-operative approach is used when the patient refuses surgery and contains: Adhesive strapping of buttocks, manual anal support during defecation, correction of constipation, electric stimulation, submucosal injection of phenol, infrared coagulation

Risks of the surgery

Bleeding, pain, stenosis, prolapse recurrence, anastomotic leakage, temporally urine incontinence, scarring reaction.

Why chose Professor Guido Mannaerts MD PhD

Is a Netherlands double board certified gastrointestinal and oncological surgeon with who is dedicated to minimal scar incision surgical approaches.
As being an Adjunct Professor at the UAE University and a broad research background Professor Guido is aiming for state of the art surgical care using the latest techniques.
His pleasant, honest, patient-centred care and being committed to achieve the best results for you makes you feel being treated like a family expert.