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  • Rectal Prolapse Surgical Treatment - Doctor Specialization

    Dear friends,

    I would like to know if any General Surgeon has the necessary knowledge to treat rectal prolapse in people with SCI or only specialized general surgeons in SCI are recommended.

    Thanks.

  • #2
    dimi,
    I have never heard of a surgeon who specializes in SCI, I don't believe there is such a critter. The surgery itself would be the same as for the able-bodied. The recovery may have to be modified however. You may want to have your physiatrist, or regular SCI doc, called in as a consult, if he has privileges at the same hospital. He could discuss any needed modifications to your post-op care, or even pre-op, with the surgeon. There are surgeons however that specialize in gastrointestinal disorders, GI surgeons, and there are even colorectal surgeons, who specialize in the lower end of the GI tract (and why anybody would choose this specialty has always escaped me )...... if you would like somebody more specific than a general surgeon. I am unsure how much skill repairing a rectal prolapse requires, but I can certainly understand why you would want it done right.

    If it were me, and I am a nurse, I would first be concerned about finding a competent surgeon. Competent in repairing rectal prolapses. I would then ask him to confer with my SCI doc, either formally as an in-house consult (he can visit you in the hospital and have access to your chart), or informally via phone/letter if he doesn't have the necessary privileges.

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    • #3
      HI,

      I agree with dunwawry above.

      I would also add that you give your surgeon a copy of the autonomic dysreflexia guidelines and assure he is familiar with the treatment; as well as the need for a good lying surface and the need for frequent turning pre- and post-op. I am not sure but this possibly could be done on an outpatient basis.

      aAD
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment


      • #4
        To add to SCI nurse (which was a very important point, AD is definitely something you want everyone to know about), if you have the surgery as an inpatient, I would have a copy of the AD guidelines posted by your bedside for the nurses. It doesn't do much good for your doc to know what to do, if the nurses don't. And I wouldn't count on them knowing, in fact, I would count on them NOT knowing. Maybe you can ask your doc to write an order to "have copy of AD guidelines posted at patient bedside" and give him a copy. Just to make things simple for everyone. KISS - keep it simple stupid, as they say. Less to get screwed up in the translation.

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        • #5
          aAD

          I am unaware of an surgical procedure for rectal prolapse repair that would be done on an outpatient basis. Would you please elaborate?

          Thank you.
          Foolish

          "We have met the enemy and he is us."-POGO.

          "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

          "Dream big, you might never wake up!"- Snoop Dogg

          Comment


          • #6
            Originally posted by Foolish Old
            I am unaware of an surgical procedure for rectal prolapse repair that would be done on an outpatient basis. Would you please elaborate?

            Thank you.
            I had the pph (pphinfo.com) done last april, only in the hospital for a couple hours. Moderate AD for about 6 hours following the procedure. Follow up 8 weeks later showed it corrected the prolapse, but still have severe colorectal pain.

            Comment


            • #7
              Originally posted by Fragile
              I had the pph (pphinfo.com) done last april, only in the hospital for a couple hours. Moderate AD for about 6 hours following the procedure. Follow up 8 weeks later showed it corrected the prolapse, but still have severe colorectal pain.
              Fragile - thanks for the info and link.

              How advanced was your prolapse? Did this procedure require an incision? If so, where and how large? Did you receive general anaesthesia? Did you have the same degree of pain prior to the procedure?
              Foolish

              "We have met the enemy and he is us."-POGO.

              "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

              "Dream big, you might never wake up!"- Snoop Dogg

              Comment


              • #8
                I am not experienced in procedures for rectal prolapse, as there are many and depends on the size and area of involvement. When you see the surgeon, ask him/her for all your options for getting this corrected.
                Getting first hand info from others that have had this problem is also helpful but eveyone is different.

                AAD
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment


                • #9
                  All I know is, if I need surgery in this area, I go to a colo-rectal surgeon. Nobody else is allowed! Make sure they are clear on AD issues. Mine had an anesthesiologist with us the whole time, to be safe.
                  Blog:
                  Does This Wheelchair Make My Ass Look Fat?

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                  • #10
                    I developed a prolapse after 6yrs of BPs. It retracted during the days but was still uncomfortable to deal with every other morning, especially when I irritated it enough to bleed. I came close to having surgery on it, but opted for a colostomy instead. Haven't had any pain since, as I no longer need to sit in a hole to take a dump, plus it gave me a LOT of independence back. There are things I dislike about it, but the pros certainly outweighed the cons, and I'm glad I made the decision. Just food for thought.

                    I agree with the notion to find a specialist. Colo-rectal / digestive health / whatever. Ask around.

                    Comment


                    • #11
                      Originally posted by Scott Pruett
                      I developed a prolapse after 6yrs of BPs. It retracted during the days but was still uncomfortable to deal with every other morning, especially when I irritated it enough to bleed. I came close to having surgery on it, but opted for a colostomy instead. Haven't had any pain since, as I no longer need to sit in a hole to take a dump, plus it gave me a LOT of independence back. There are things I dislike about it, but the pros certainly outweighed the cons, and I'm glad I made the decision. Just food for thought.

                      I agree with the notion to find a specialist. Colo-rectal / digestive health / whatever. Ask around.
                      Thanks for this, Scott.
                      Foolish

                      "We have met the enemy and he is us."-POGO.

                      "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

                      "Dream big, you might never wake up!"- Snoop Dogg

                      Comment


                      • #12
                        Originally posted by betheny
                        All I know is, if I need surgery in this area, I go to a colo-rectal surgeon. Nobody else is allowed!
                        Personally, I agree. When I have had to have a pilonidal cyst excised, another nasty procedure and twice no less, I went to a colorectal surgeon as well. He told me I was the first patient he ever had to go back and redo. I felt so special.

                        He suggested that while I was at it the second time, I allow him to excise four hemorrhoids, two internal. They weren't particularly bothering me, and doing this was going to change the procedure from an outpatient one to one that would require a two-day inpatient stay for pain control. While I was at it???? I told him I didn't think so! Seven years later my hemorrhoids continue to rarely be an issue (occasionally with diarrhea only), seeing that I am no longer able to "push" to any significant degree with BM's anyways. Guess he had to wait on the wife's new car. Sometimes you have to use plain old common sense when making decisions about your healthcare. The cure should never be worse than the disease.

                        Comment


                        • #13
                          Originally posted by Foolish Old
                          Fragile - thanks for the info and link.

                          How advanced was your prolapse? Did this procedure require an incision? If so, where and how large? Did you receive general anaesthesia? Did you have the same degree of pain prior to the procedure?
                          Not very advanced, wasn't protruding.

                          Yes, the procedure involves an incision inside the colon to cut away excess mucosa after pulling the droopy mucosa back into place. Complete circle around the inside of the colon.

                          They completely knocked me out for about 45 minutes.

                          Still in just as much pain, sometimes worse. Going to try a nerve block on Feb. 29.

                          If you can get it to open, there's an animation at pphinfo.com.
                          Last edited by Fragile; 02-14-2008, 04:54 PM.

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                          • #14
                            Scott, I am facing my first surgery for prolapse, that is in the advance stage of being a full-prolapse. I have suffered severe IBS for the last 20 years now, it affects everything I do when it fills like it. I have been doing extensive research about the prolapse surgeries and have read a lot more negative things than positive ones, no matter how the surgery is done. The only real positive feedback I see is the colostomy decision to really make the right changes I am seeking so desperately. I am tired and my body is tired after the last 20 years of pain and all the colonoscopies and GI test. Now the prolapse is just about all I can stand. I am so afraid that if it is only corrected then it will just return again or I will have worse IBS than before. So this is the reason I am looking into having the colostomy done instead. Thank you for any advice y may have.

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                            • #15
                              Originally posted by denisejohnson View Post
                              Scott, I am facing my first surgery for prolapse, that is in the advance stage of being a full-prolapse. I have suffered severe IBS for the last 20 years now...Thank you for any advice y may have.
                              What is your level and type of spinal cord injury? You have posted here again on a very old thread with these questions. These forums are primarily for those with paralysis due to spinal cord injury or disease. If you do not have one of those conditions, you will find much better information on a forum designed for those with IBS or colitis/ileitis.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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