Paraproctitis is inflammation of the tissues near the rectum (pararectal tissue) due to the penetration of infection into them. Often formed abscess (limited space with purulent contents), this is called acute paraproctitis. An abscess of perirectal tissue can break out on its own, but the process often becomes chronic, forming rectal fistulas (chronic paraproctitis).
Paraproctitis is one of the most common proctological diseases, the only more common ones are hemorrhoids, anal fissure and colitis. The most common causes of paraproctitis are infection of the perirectal tissue, most often through the rectal mucosa (microtraumas and cracks in the mucosa due to constipation, hemorrhoids, etc.). d.).
Prerequisites for development
There are a huge number of reasons that can contribute to the development of pathology. Among them:
- Frequent intestinal disorders or constipation
- Infectious diseases (disorders of normal functioning, performance)
of the intestinal tract, digestive coli - STD
- Haemorrhoids
- Traumatization of the rectum
- Untreated anal fissures
- Colitis
- Crohn's disease
- Decreased immunity
- Poor nutrition – predominance of fatty and spicy foods in the menu
- Alcohol abuse
- Special physical overload, lifting heavy objects
- Failure to comply with hygiene standards
The totality of circumstances describes the main category of patients of the proctologist - most often men aged 25-50 years turn to the doctor with paraproctitis.
Postoperative period
After surgery, it is recommended for wound healing:
- careful hygiene of the operation area - that is, washing this area at least 6-7 times a day with a stream of warm water. The use of constant compresses, ointments and lotions is not required;
- monitoring the effectiveness of pain relief. Our clinic specialists select the optimal regimen and methods of using various drugs to control pain.
In some cases (after plastic surgery or in the presence of severe inflammation), antibiotics are necessary.
In addition, a diet correction is necessary, including foods high in fiber and various liquids, excluding spicy, spicy and sour foods, and alcohol, so that the stool is soft and does not injure the surgical site. Upon discharge from the clinic, the doctor gives detailed recommendations on nutrition and lifestyle.
It is necessary to remember about specific therapy in the presence of inflammatory bowel diseases (Crohn's disease, Ulcerative colitis, etc.), as well as the high risk of re-formation of fistulas in the presence of post-radiation fistulas (in patients who have undergone radiation therapy courses) and in patients with Crohn's disease, which requires careful monitoring in the postoperative period.
Cost of treatment
Free treatment under compulsory medical insurance policy
A type of social insurance for citizens of the Russian Federation, which provides guarantees of free medical care in the detection of surgical diseases.
Quota treatment (VMP)
Providing medical care for the most severe diseases of the gastrointestinal tract, requiring the mandatory use of expensive instruments and/or the use of complex surgical techniques.
Treatment on a paid basis
It assumes the possibility of receiving medical care for any surgical disease, regardless of the presence of a compulsory medical insurance policy, without the need to complete additional documents and obtain a quota, for citizens of all countries of the world.
Acquired paraproctitis (rectal fistulas)
In case of incorrect treatment (process for alleviation, removal or elimination of symptoms and disease)
acute paraproctitis, independent breakthrough of an abscess or under the influence of other causes, the internal opening of an abscess
(that is, an abscess, or purulent inflammation)
forms a fistula. A perianal fistula is a narrow canal connecting the anus to an opening in the skin near the anus. Acquired paraproctitis is characterized by stages of remission and exacerbation.
Pus can accumulate in the lumen of the fistula, causing swelling and pain. The fistula can drain (break through) without the help of others, in which case the symptoms (Symptom from Greek - case, coincidence, sign - one separate sign, frequent manifestation of a disease, pathological condition or disorder of any vital process)
disappear for a while, and return when the lumen of the fistula becomes clogged again. Repeated exacerbations occur due to constant infection of the fistula with pathogenic flora of the rectum.
Symptoms of acute paraproctitis:
Symptoms of acute paraproctitis depend on the location of the source of inflammation and other factors. The most characteristic symptoms:
- Pain in the anal area; pain may intensify during bowel movements, physical activity, prolonged sitting, etc.; pain can be localized not only in the rectum, but also in the lower abdomen
- Deterioration of general condition - low-grade fever (37-38), weakness, loss of appetite
- Redness of the skin, swelling and tightening of tissue in the anus, sharp pain when pressed (when located in the subcutaneous tissue space)
With acute paraproctitis, symptoms may increase (pain intensifies, general health continues to deteriorate). In some cases, the condition improves dramatically, with pus and blood appearing in the stool. This means that the abscess has broken into the rectum. If there is a breakthrough or improper treatment of acute paraproctitis, there is a high risk of the disease becoming chronic. In addition, paraproctitis is dangerous due to the spread of purulent inflammation to the pelvic organs, abdominal cavity, and other serious complications.
Healing paraproctitis
The most effective way to treat both acute paraproctitis and rectal fistula is surgical.
The operation is performed under anesthesia. Local anesthesia is not used in this case, because it is very important to completely anesthetize the surgical field and relax the muscles. During the operation, the abscess is opened, and the patient is drained of pus. But this is not the end of surgical healing if we are talking about an acquired form of the disease (disturbances in normal functioning, performance)
– it is important to remove not only the abscess, but also the fistula itself.
This cannot always be created at the time of active inflammation. Therefore, in some cases, two operations are performed - one to open the abscess (that is, an abscess, or purulent inflammation)
, the second to excise the fistula.
From time to time, as part of preoperative preparation, the patient is prescribed a course of anti-inflammatory and bactericidal therapy (therapy is a process to relieve or eliminate symptoms and manifestations of the disease)
, and physiotherapeutic methods have also proven themselves to be excellent.
At the Treatment and Diagnostic Center of the Central Clinical Hospital of the Russian Academy of Sciences (Russian Academy of Sciences - State Academy of Sciences, the highest scientific organization of the Russian Federation, a leading center for fundamental research in the field of natural and social sciences)
operations for acute paraproctitis and excision of the fistula are carried out in the operating unit of a day hospital. The introduction of modern anesthetics eliminates unpleasant feelings during surgery. After the intervention, the person is under the supervision of a doctor for several hours, after which he can go home without the help of others, having received the necessary advice on postoperative healing.
Advantages of treatment in our clinic
- Extensive experience in performing transanal and transvaginal ultrasound, colposcopy (examination of the vaginal walls, the vaginal part of the uterus using a special instrument inserted through the vagina), anoscopy (examination of the mucous membrane of the anal canal), sigmoidoscopy (examination of the mucous membrane of the rectum and part of the sigmoid colon) - instrumental methods necessary to examine the opening of the fistula tract, assess the location, length, course of the fistula, in order to determine further treatment tactics.
- Availability of modern diagnostic equipment (CT, ultrasound, MRI, etc.), which is of great importance for differential diagnosis and determination of involvement of other organs in the tumor process. Our center has a high-resolution MRI scanner. Currently, MRI is recognized as the “gold standard” for imaging pelvic tumors.
- Extensive experience in the surgical treatment of acute and chronic paraproctitis, including complex cases with complications (for example, purulent leaks and complex fistulas).
- In our clinic, treatment of the disease is based on a multidisciplinary approach with the participation of a gynecologist, coloproctologist, and surgeon, which allows us to select the optimal treatment regimen for each patient.
- Following modern European protocols for the treatment of diseases of the anus, as well as a protocol for rapid recovery after surgery.
- There is no need for bowel preparation (enemas, laxatives) before surgical treatment.
- Individual selection of the method of anesthesia during surgery allows you to minimize the possible stress from the operation itself and your stay in the clinic.
- Performing the operation using the latest equipment allows it to be performed bloodlessly, with minimal damage to the patient’s skin and tissues, and also to achieve an optimal cosmetic effect.
- The use of pre-emptive analgesia allows you to minimize pain after surgery, which allows you to return to a full life on the first or second day after surgery.
- An individual approach to each patient, the focus of treatment not only on eliminating the disease itself, but also on its possible causes. This reduces the risk of recurrence of the disease.
- Development of recommendations for correcting nutrition and lifestyle for each patient after surgery.
Consultation with a proctologist
Any suspicion of paraproctitis is a reason for an immediate appeal to a proctologist and an urgent operation if the diagnosis is proven (a brief medical report about the existing disease (injury), deviation in the health status of the person being examined or the cause of death)
.
If healing is not carried out or the source of infection is not eliminated (the term means various types of interaction of foreign microorganisms with the human body)
, paraproctitis develops into an acquired form, and over time a fistula tract is formed. During the consultation, the proctologist will conduct a diagnosis by palpation and visual examination. He will determine the severity of the condition and recommend a more effective method of combating the disease.
We perform laser treatment of paraproctitis of the rectum - an operation to open and drain the area without a traditional scalpel and general anesthesia. Healthy tissues (The structure of tissues of living organisms is studied by the science of histology)
are not damaged.
Healing of acute and acquired paraproctitis with complete removal of formations, inflammation and advice, drug therapy (Therapy from the Greek [therapeia] - treatment, recovery)
to prevent relapses.
High-temperature laser treatment of the purulent cavity, the wall and bottom of the purulent cavity, leads to the removal of infection (The term means various types of interaction of foreign microorganisms with the human body)
and rapid tissue scarring and healing. The method will be included in Russian clinical councils until 2022.
- Elimination of pain in the rectal area and incorrect urge to defecate, a sharp reduction in intoxication of the body.
- Complete removal of infection (The term means various types of interaction of foreign microorganisms with the human body)
from a purulent focus. - Fast healing.
- Healing, clinical effect.
Advantages of the method
The cost and treatment plan are determined after consultation with a proctologist and video rectoscopy. Computed tomography may be required (obtaining a layer-by-layer image of the internal structure of the object)
.
In case of very deep paraproctitis (ischiorectal, pelviorectal or retrorectal), treatment will be offered at a Moscow proctology hospital with surgery performed under general anesthesia.
If the paraproctitis is acute and the affected area is insignificant, then an operation to open the paraproctitis and laser treatment of the purulent focus on the day of admission is likely (critical surgery).
| Service | Ancient cost | New price until 03/31/2021 |
| Opening and laser treatment of the paraproctitis cavity (small spread of inflammation) using Biolitec technology (Germany) | 60,000 rub. | -20% 48,000 rub. |
| Opening and laser treatment of the paraproctitis cavity (complex types of paraproctitis) using Biolitec technology (Germany) | 78500 rub. | -30% 54950 rub. |
| Opening and laser treatment of the paraproctitis cavity using Mediola laser fibers (Belarus) | 45,000 rub. | |
| Examination and dressing | 3000 rub. | -10% 2700 rub. |
| Stay in the ward, antibiotic therapy after surgery | 3000 rub. | -10% 2700 rub. |
The number of dressings depends on the healing process and, naturally, on the size of the intervention. It is impossible to do without dressings for such a pathology.
During a critical intervention, blood is drawn (from the internal environment of the human and animal body)
in our clinic to comply with the standards for providing paid medical care in the Russian Federation
(the Russian Federation is a state in Eastern Europe and Northern Asia, our Motherland)
.
Rehabilitation
Treatment methods after surgery to remove paraproctitis depend on the type of surgery performed. Dressings are performed regularly. Antibiotics are indicated. In some cases, during dressings, the patient is recommended to do weak manganese sitz baths. Medications to temporarily hold stool or laxatives may be prescribed. Patients in the postoperative period need a special diet. On average, recovery takes 3-4 weeks.
You can find out the exact price for opening paraproctitis after a face-to-face consultation with a proctologist. You can make an appointment 24/7 by calling SM-Clinic.
Find out more information by phone or fill out the online form - the administrator will contact you to confirm your appointment.
SM-Clinic guarantees complete confidentiality of your request.
Devices and light guides
We use Biolitec and LAMI 1470 laser devices, registered in Russia. They differ in flexibility and accuracy of options, reliability. What is needed for effective, safe and predictable healing.
For laser obliteration of the purulent cavity with paraproctitis, we use FiLaC circular laser fibers (Germany), and Mediola fibers are a candidate for lowering the price of the service.
Advantages of our clinic
- Russian and German laser. There is an opportunity to save and choose the Mediola laser as a candidate for Biolitec technology.
- Unique consumables. We use only consumables recommended by laser manufacturers. Sterile. After introduction they are destroyed.
- Doctors' experience. The center's proctologists are at the forefront of introducing laser in the treatment (a process for alleviating, relieving or eliminating symptoms and diseases)
of paraproctitis. They achieve good results without relapses and with rapid recovery. - Guaranteed good results. Proctologists will offer healing only if they are completely convinced of a positive outcome. In case of advanced variants of the disease (impaired normal functioning, performance)
or any doubts from the doctor, the patient will be sent to the hospital. - Local anesthesia. We use only local anesthesia, it dramatically reduces rehabilitation time and the period of disability!
- Legitimate. We treat according to an understandable contract, and upon payment (payment for the purchased product or service received)
we give a receipt. We follow the rules of European and state clinical councils based on Federal Law No. 489 of 2021. - Anonymity. Complete anonymity and compliance with the law on doctoral confidentiality.
How is healing carried out?
- Local anesthesia. Removes pain, but slight discomfort may be felt at a low pain threshold.
- Opening and drainage of the purulent cavity of paraproctitis. Removing pus, washing the cavity with antiseptics. Preparation for exposure to a laser beam.
- Laser processing. Additional local anesthesia is carried out followed by laser treatment of the purulent focus.
- Ending. Applying a bandage. The patient is sent to the ward for bed rest for 2 hours.
What to do after paraproctitis removal?
- It is important to arrive on time for dressing changes. Their regularity after healing of a purulent lesion is the key to rapid recovery and absence of relapses.
- Compliance with diet. Taking systemic medications, ointments and suppositories. Medicines are prescribed personally according to certificates.
- For 1 week, it is not recommended to take a shower for the body one hundred percent; for 4 weeks, avoid physical activity.
After laser removal of paraproctitis, there is no pain syndrome (a set of symptoms with a common pathogenesis)
. There is relief. The temperature will normalize, the unpleasant phenomena in the rectum and the incorrect urge to defecate will disappear.
The technique is being intensively developed in European countries. The most extensive experience in Germany and the Baltic countries.
INDICATIONS
Laser treatment of a purulent focus of paraproctitis of the rectum on an outpatient basis is carried out for subcutaneous, submucosal, and intrasphincteral forms. In all other cases, it is necessary to open and drain the purulent cavity in a hospital setting under general anesthesia.
Contraindications
- Laser surgery is not recommended for paraproctitis in ischiorectal, pelviorectal or retrorectal forms.
- Laser surgery is not recommended for the deepest forms of damage, when the purulent process is generalized and drainage installation is required.
Possible complications
- Continuation of the infectious process in the tissues (if the process was deep).
- Formation of fistulas - in the rectum, uterus, bladder.
- The spread of infection (the term means various types of interaction of foreign microorganisms with the human body)
into the pelvic cavity with the development of peritonitis.
Complications after laser removal of paraproctitis occur very rarely. It all depends on the degree of purulent lesion, anatomy, and the state of the patient’s immune system.
Symptoms of the disease
The insidiousness of a long-term fistula is that it practically does not cause any acute or severe symptoms. During periods of exacerbation, the patient may complain of characteristic discharge, increased body temperature, causeless sweating, mood swings, and decreased performance. There are no painful sensations. The fistula can break out on its own. Then for a while the symptoms disappear completely. But when the lumen becomes clogged with secretions again, the signs of the disease return.
