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Old 04-20-2010, 07:05 AM   #1
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Unhappy My surgeon wants me to have a starr procedure.

I am a 36 year old female, and after 9 years of symptoms and a failed laparoscopic rectopexy in October last year, my surgeon thinks I may benefit from a starr procedure. I have a complete lack of urge to open my bowels, pain, bloating, and some urinary retention at times. I was diagnosed with an internal rectal prolapse and rectal intussuception. My surgeon wants to put me under, look at what they did with the rectopexy, and if that looks ok and there is still some prolapsing, then perform the starr procedure. However, I am fairly reluctant to have this done, as I have read a lot of negative feedback, mostly to do with extreme urgency, pain and infection. I don't want to be worse off than I am now, which is bad enough - I don't think I could cope with more severe symptoms. I would be grateful to hear about anybody's experience of this procedure, particulary anybody with similar symptoms to mine. Thanks

 
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Old 04-20-2010, 11:41 AM   #2
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Re: My surgeon wants me to have a starr procedure.

Gramber, I am having the same issue. I have colonic inertia, which is a severe form of slow transit constipation, and I have an outlet problem. I take miralax to help with the colonic inertia, but the outlet problem is very hard to control. I have had 2 surgeries for pelvic prolapses, the last one in 2006 which was a sacralcolopopexy. This is where the surgeon used mesh to attach my pelvic floor to my tailbone. I had a rectecele, cystocele, and a dropped uterus, which the doctor removed.

I have to use suppositories and many more creative bathroom acrobats to have a bm. It takes hours of my day to have a bm. I just had the defogram today and boy was that humiliating....I have had many many tests to try and figure out why I can't have a normal bm. The doctor suspects intusseption????? All I know is I could not empty the barium no matter how long and hard I pushed.

Are you like this?

 
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Old 04-21-2010, 01:04 PM   #3
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Re: My surgeon wants me to have a starr procedure.

Hi luckycharms. It sounds like we have a few similar problems. I spend on average of about 2 hours in the bathroom every evening trying to empty my bowels! I can only go using suppositries, and even then it is a real struggle. I had a rectopexy, where I had a mesh fitted to keep everything in place - I wonder if this is the same procedure you had with a different name? I have had loads of different tests done, and I have come to the conclusion that there are various things wrong, and they're not quite sure how to fix them! I think these problems can be so complex - I think I have a lot of nerve damage and this is being addressed if my next procedure fails. I am absolutely terrified of having anything else done, because it was so awful after my last surgery. Has the starr procedure been discussed with you? Although it is awful to have to go through these problems, it is helpful to find others in a similar position, as I have suffered in silence for years. What's the next step for you?

 
Old 04-21-2010, 06:01 PM   #4
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Re: My surgeon wants me to have a starr procedure.

Gramber, I have the xrays from the defogram and my rectum is very obviously abnormal. I am not a doctor, yet I can see it is not normal. It looks collapsed, crooked, and has a severe bend in it. When I pushed down to try and expel the barium paste, I pushed for 3 minutes and not one drop of the barium came out.

Have you ever had this dreaded test?

I have been reading all about these outlet issues and it seems there is no easy fix for any of them.

I have read about the starr procedure and I think it is still experimental and I did not read many positive outcomes from the people that had it performed. I don't think this will help my issue anyway.

Do you have to manually disimpact? I use suppositories, but ALWAYS have to manually remove stool from my rectum because my "push" seems to be broken. I had an emg, pudendal nerve studies, anal ultrasound, anal manometry, and 2 defograms. The emg was normal with the rectum relaxing when I bare down . The pudendal nerves are working and does not indicate any nerve damage.The anal manometry was abnormal with high resting pressures and my sensations were off.

What tests have you had and what were the results?

 
Old 04-22-2010, 06:07 AM   #5
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Re: My surgeon wants me to have a starr procedure.

Quote:
Originally Posted by luckycharms View Post
Gramber, I have the xrays from the defogram and my rectum is very obviously abnormal. I am not a doctor, yet I can see it is not normal. It looks collapsed, crooked, and has a severe bend in it. When I pushed down to try and expel the barium paste, I pushed for 3 minutes and not one drop of the barium came out.

Have you ever had this dreaded test?

I have been reading all about these outlet issues and it seems there is no easy fix for any of them.

I have read about the starr procedure and I think it is still experimental and I did not read many positive outcomes from the people that had it performed. I don't think this will help my issue anyway.

Do you have to manually disimpact? I use suppositories, but ALWAYS have to manually remove stool from my rectum because my "push" seems to be broken. I had an emg, pudendal nerve studies, anal ultrasound, anal manometry, and 2 defograms. The emg was normal with the rectum relaxing when I bare down . The pudendal nerves are working and does not indicate any nerve damage.The anal manometry was abnormal with high resting pressures and my sensations were off.

What tests have you had and what were the results?
luckycharms I have had some nerve studies, for which I have never recieved a clear result. When I last saw my consultant, I stupidly forgot to ask, as there was so much else to discuss. My defogram - which was incredibly humiliating - showed up my intussuception, which is what the rectopexy was meant to fix. I do wonder if they will ever "fix" me - I sometimes feel like asking them to give me a colostomy bag as I have almost given up hope of performing a normal bodily function.
I don't have to manually evacuate, and I'm sorry you have to go through that. I have to take 6-8 Movicol sachets a day, and use suppositries, which, although difficult and uncomfortable, usually works. I feel like my push is broken too - that's a good way of describing it. I never would have dreamed I would have these problems, or have to talk about these things. Unless you have had some experience of it, you can't understand how awful it is. I have not told anybody else, but my consultant, about all of my problems.
Do let me know what happens next for you.

 
Old 04-22-2010, 09:06 AM   #6
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Re: My surgeon wants me to have a starr procedure.

I do think I may have rectal intusseception, but it only shows at the end of the defogram, after the barium paste has been emptied and I didn't empty one drop.

Have you repeated the defogram since your last surgery? I think a repeat of the defogram is vital so the doctor can see exactly what is still wrong.....

Why does he think the starr will work for you?

I also am considering getting a "bag"! If the doctor can't fix me, then I will have to have a stoma installed so I can atleast poop!

My life revolves around pooping....

 
Old 04-28-2010, 01:45 PM   #7
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Re: My surgeon wants me to have a starr procedure.

Hi luckycharms. I am not booked to have any other tests before my next surgery. I think I have decided against having a starr procedure done, as I am not confident that It will make any positive difference. My surgeon wanted to do it if when they had another look there was still some prolapsing that the rectopexy didn't fix. I think I have a lot of nerve damage, and may need something fitted to stimulate my nerves in my bowel to work, which will be the next step if my next surgery doesn't work. I am so tired of these problems - like you my life revolves around the bathroom! Keep me posted as to what happens next with you.

 
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rectal intussuception, rectal prolapse, rectopexy, starr



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