Colorectal Surgeon and General Surgeon, Dr Stephen Allison






Surgery for Constipation

Anorectal Physiology

What is Anorectal Physiology?

Anorectal physiology is used to investigate constipation and faecal incontinence.

The storing and passing of faeces is controlled by:-

Anorectal physiology is the measurement of compliance of the rectum, the pressure in the anal sphincter, pudendal nerve studies and ultrasound of the anal sphincter.

It is performed by Dr Allison in the day surgery of the Greenslopes Private Hospital and requires no anaesthetic.

It is often done in association with a defaecogram performed in the x-ray department.

This study helps Dr Allison to understand the cause of your incontinence or constipation and to advise you of your treatment options.

Laparoscopic Pelvic Floor Repair for
Pelvic Floor Prolapse

What is the Pelvic Floor?

The pelvic floor is the hammock of muscles in the pelvis which support the intra-abdominal organs especially the bladder, bowel and uterus. When the pelvic floor becomes weak these organs prolapse through it creating a hernia into the vagina. This causes difficulty passing bowel motions and urine and can be uncomfortable.

Pelvic Floor Repair Explained

Pelvic floor repair can be performed by either laparoscopic or open approach. Dr Allison has a extensive experience with both, and feels the laparoscopic approach gives a better outcome and superior recovery.

For laparoscopic pelvic floor repair four ports (tubes) are placed into the abdomen through small cuts on the skin. Through these ports a telescope and operating instruments are placed. A piece of mesh is stitched to the vagina and then fixed to the sacrum (part of the bony pelvis) to ensure the vaginal vault stays in place.

Usually patients stay in hospital for 2 to 3 days.

Postoperative Recovery for Pelvic Floor Repair

You will need to avoid heavy activity for 6 weeks. This allows the repair to become solid.

Light duties are required after this operation. This means NO heavy lifting. Carrying a cup of tea or coffee is OK. Carrying out the washing to hang on the line, mowing the lawn, or doing the house work should be avoided for a period of 2 weeks to ensure adequate wound healing and strengthening. Heavier physical activities, such as returning to the gym or competitive sports, should not resume until 6 weeks after the operation.

For a consultation, diagnosis and further advice on pelvic floor prolapse and constipation, please contact us on (07) 3397 2634 for an appointment with Dr Allison.

Rectocele Repair

What is a Rectocoele?

A rectocoele is a hernia of the lower bowel or rectum into the vagina. It creates a pocket where the stool becomes lodged during defecation making it difficult to empty the bowel – this is called obstructed defecation. Patients report difficulty emptying the bowel or requiring several bowel movements to feel empty.

Sometimes there is an associated injury to the anal sphincter and patients may also report faecal incontinence.

Rectocoele Repair Explained

Patients presenting to Dr Allison with this problem require investigations which may include a colonoscopy to ensure there is no bowel cancer causing the symptoms, a defaecogram (where dye is placed in the rectum and an x-ray is taken) and anorectal physiology (click here).

Before the operation to repair the rectocoele, an enema is given to evacuate the rectum.  An incision is made between anus and vagina. The rectocele is defined by separating the rectum from the vagina and repaired using a biodegradable mesh. This mesh makes the repair strong.

After the procedure, you will have a pack in your vagina, and a catheter in the bladder. They will both be removed on the second postoperative day. The wound is left slightly open to allow discharge to drain rather than create a collection which could potentially become infected.

For a consultation, diagnosis and further advice on rectocoeles, please contact us on (07) 3397 2634 for an appointment with Dr Allison.

 

Content on this page requires a newer version of Adobe Flash Player.

Get Adobe Flash player

Bowel (Colon) Resection for Constipation

Why Resect the Bowel for Constipation?

Sometimes constipation is caused by redundant, overly-long, large bowel which increases the transit time for the faeces.

Patients presenting to Dr Allison with this problem require investigation which may include a colonoscopy to ensure there is no bowel cancer causing the symptoms, a defaecogram (where dye is placed in the rectum and an x-ray is taken) and anorectal physiology (see previously).

Resection of the large bowel is called colectomy.

Colectomy Explained

Colectomy for constipation is usually performed by a laparoscopic (key-hole) approach.

Four ports (tubes) are placed into the abdomen through small cuts on the skin. Through these ports a telescope and operating instruments are placed.

The redundant colon is mobilised and removed through one of the port sites. The remaining bowel is joined together, and the anastomosis (join) is tested to ensure it is intact.

For a consultation, diagnosis and further advice on bowel cancer, please contact us on (07) 3397 2634 for an appointment with Dr Allison.

Please let us know that you require a consultation for cancer and you will be seen the same week.

Sacral Nerve Stimulation

What is Sacral Nerve Stimulation?

The sacral nerves control the function of the rectum where the faeces are stored before a bowel movement.  They are found in front of the sacrum which is the tail bone at the base of the spine. Electrical stimulation of these nerves can improve both faecal incontinence and constipation.

Sacral Nerve Stimulation Explained

Initially a temporary stimulation wire is inserted through the sacrum onto the sacral nerves. This is attached to a temporary pulse generator (battery) which is about the size of a small mobile phone and worn on your belt. Constant stimulation to the sacral nerves is produced. At home you will keep a diary of bowel function.

About 2 to 3 weeks after the temporary wire has been implanted your response is assessed by Dr Allison. The device will be removed in Dr Allison’s rooms. A discussion will then occur about the effectiveness of the device. If appropriate, a permanent sacral nerve stimulator will be inserted. At this procedure a permanent wire is inserted through the sacrum and attached to an implantable pulse generator which is placed under the skin in the buttock. Everything is internal with no external wires.

Both the temporary and permanent devices are implanted under sedation with local anaesthesia.

For a consultation, diagnosis and further advice on faecal incontinence, constipation and sacral nerve stimulation, please contact us on (07) 3397 2634 for an appointment
with Dr Allison.