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What can be done for a man who had his prostate

Sent to Health Experts August 07, 2006 3:40 p.m.

What can be done for a man who had his prostate removed and underwent broad radiation treatment resulting in a greatly compromised anal sphincter (external and internal) and a rectal prolapse? He experiences incontinence and prolapse numerous times each day and is an otherwise health 90 year old.

Optional Information:
Male , Age: 90

Already Tried:
hygiene care only.

Customer (name blocked for privacy)

Status: Closed Value: $15

Answer
August 07, 2006 8:55 p.m. (5 hours and 15 minutes later)

REPLIED

One approach would be to perform a diverting colostomy. A colostomy is surgical procedure to connect the large intestine to an opening on the abdominal wall. A pouch is placed over the opening, allowing the person to collect the stool in a controlled manner, eliminating the embarresment and inconvienience of the incontinence.
http://www.nlm.nih.gov/medlineplus/tutorials/colostomy/htm/index.htm

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Reply to Family Physician
Sent August 08, 2006 2:22 p.m. (17 hours and 26 minutes later)

Thank you for your response to my question. I fear that a diverting colostomy is too aggressive. This man does have some sphincter control but he must constantly think about it or risk incontinence. For the prolapse there is a sling like surgical procedure that can keep it in place. What can be done to help with the sphincter control? Bowel training? Surgical reconstruction of the muscle? Can the bowel be fashioned into a psuedo-sphincter as is sometimes done with the esophagus at its junction with the stomach? Thank you for the additional time spent on my question.

Customer (name blocked for privacy)

Answer
August 08, 2006 3:15 p.m. (53 minutes and 30 seconds later)

ACCEPTED

There are a number of things that could be tried. The problem is that radiation causing scar tissue to form, and surgery in this area after radiation would be much more difficult. Also, wound healing is not as good in areas that have had radiation.

A colo-rectal surgeon would be the specialist who would do this kind of procedure. It is a reasonable thing to consider - my suggestion was based on the fact that this might have been a simpler procedure particularly for a 90 year man.

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 3345 Health Accepts
Physician with 22 years experience in Emergency Medicine / Family Medicine

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