Perirectal injection of sclerosing solution for prolapse
CPT4 code
Name of the Procedure:
Perirectal Injection of Sclerosing Solution for Prolapse
Common names: Sclerotherapy for rectal prolapse, Injection of sclerosing solution
Summary
This procedure involves injecting a sclerosing (hardening) solution into the tissue around the rectum to treat rectal prolapse, a condition where the rectum protrudes from the anus. The solution causes scarring and tightening of the tissue, helping to hold the rectum in place.
Purpose
Medical Condition: Rectal prolapse, which is when part of the rectum slips outside the anus. Goals: To create scar tissue that stabilizes and supports the rectum, reducing or eliminating prolapse and associated symptoms like discomfort, bleeding, and incontinence.
Indications
- Visible rectal prolapse
- Symptoms such as pain, bleeding, or fecal incontinence
- Previous unsuccessful non-surgical treatments
Patient Criteria: Typically considered for patients who are not ideal candidates for more invasive surgical options due to age, overall health, or preference.
Preparation
- Fasting for at least 6 hours before the procedure
- Adjusting current medications as directed by the healthcare provider
- Completing necessary diagnostic tests like a colonoscopy or imaging studies to assess the extent of the prolapse
Procedure Description
- The patient is positioned comfortably, usually lying on their side.
- Local anesthesia or light sedation is administered for comfort.
- The healthcare provider cleans the area around the rectum with an antiseptic solution.
- Using a specialized needle, the sclerosing solution is injected into the tissue surrounding the rectum.
- Multiple injections might be performed to ensure even distribution of the solution.
- The procedure is completed once the healthcare provider confirms adequate coverage and response of the tissue.
Tools and Equipment: Antiseptic solution, syringe, injection needle, sclerosing solution.
Anesthesia: Local anesthesia or light sedation.
Duration
Typically takes around 30-45 minutes.
Setting
Outpatient clinic, surgical center, or hospital setting equipped for minor procedures.
Personnel
- Gastroenterologist or colorectal surgeon
- Nursing staff
- Anesthesiologist or nurse anesthetist (if sedation is used)
Risks and Complications
- Common: Pain or discomfort at the injection site, minor bleeding, transient swelling
- Rare: Infection, allergic reaction to the sclerosing solution, unintended tissue damage
Benefits
- Reduction or resolution of rectal prolapse
- Improvement in symptoms like pain, bleeding, and incontinence
- Quick recovery time compared to more invasive surgical options
Recovery
- Some discomfort and minor bleeding may occur for a few days post-procedure
- Patients typically resume normal activities within a day or two
- Follow-up appointments to monitor the success of the treatment and address any complications
Alternatives
- Observation and Lifestyle Modifications: For mild cases with lifestyle adjustments to manage symptoms.
- Surgical Repair: More invasive but generally more definitive treatment; requires longer recovery.
- Pelvic Floor Therapy: Non-invasive but may not be effective for severe prolapse.
Pros and Cons: Sclerotherapy is less invasive and has a quicker recovery time, but it may not be as effective as surgical repair for severe cases.
Patient Experience
Patients may feel minor discomfort during the injection but generally find the procedure tolerable. Post-procedure pain is usually mild and manageable with over-the-counter pain medication. Any discomfort typically resolves within a few days, with most patients experiencing significant symptom relief within a week.