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Hi All-- Dr. Shen was my doc at the Cleveland Clinic and is now at Columbia.  He believes (based on a video appointment) that my pouch is somewhat prolapsed.  He has a new banding procedure that is supposed to help with this.  I don't fully understand it but the basic idea is that he'll put something similar to large rubber bands on the pouch which will cause scar tissue to form, which will help stop the prolapsing,   There are no published data on this.

Has anybody done this?   If so, did it help?  Any problems?

Thanks so much,

Debbie

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I have not heard of banding for pouch prolapse, but banding of hemorrhoids has been around for ages. I was just not sure how it would apply for prolapse. But, Dr. Shen is the expert when it comes to problem pouches and most treatments for prolapse are fairly major. So, anything that is a simpler outpatient procedure is a good thing. I did a bit of looking and found that Dr. Shen has been doing this for a couple of years. Here is a link that discusses the procedures he can do via endoscopy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383159/

Jan

Yes not many do this procedure and he never trained anyone how to do this either at Cleveland Clinic. I have heard its only about 60% effective. How did he diagnose your prolapse and what are your symptoms? When Remzi first did my redo Shen told me I had a small prolapse, and said treat it as I would a hemrhoid  I don't believe I have ever had an issue with this"prolapse". Dr Remzi said its not a prolapse and my new GI and surgeon who have scoped me since never mentioned it.. Don't get me wrong I love Dr Shen, as I had him for 11 years.

Hmmm -- I have not been diagnosed with the prolapse.  When I did a video appointment with Dr. Shen last year he said he was suspicious of a prolapse.  But i"ve had my pouch 20 years and my symptoms haven't changed much so I'm not sure.  I'm going to NY to see him anyway because I haven't seen him in about 8 years and I don't trust anyone here (in Northern CA) so I'll see what he has to say.  He will do a decography before I agree to the banding in any case.  Do you know of any down sides to the banding?   Do you have any idea how many he has done?  And where did you get the 60% figure? 

Thank you,

Debbie

lclassen, I cannot help you with your question. You should see Dr. Shen or some experienced pouch specialist in your area.  The past issue I had with my J Pouch was not a prolapse, but rather a septum that developed within the pouch, which was corrected with a surgical revision of the Pouch performed by my original surgeon, and not any procedure along the lines of what has been discussed in this thread.

@lclassen posted:

This is an interesting topic.  I've been wondering if the pouch could prolapse.  What does it feel like?  For me, it feel like my pelvic floor has dropped down, put I can "push" it back up into place.  @scallop  or @CTBarristerr, do my symptoms sound like prolapse?

I agree with others that if you think you might have a prolapsed pouch a proper physical exam is the next step. There are two kinds of prolapses: mucosal prolapse and full-thickness prolapse. The treatments are very different.

@lclassen posted:

This is an interesting topic.  I've been wondering if the pouch could prolapse.  What does it feel like?  For me, it feel like my pelvic floor has dropped down, put I can "push" it back up into place.  @scallop  or @CTBarristerr, do my symptoms sound like prolapse?

I have had the banding procedure for prolapses done a few times. Unfortunately it has happened numerous times but each time Dr Shen has been able to fix the problem. Let me know if you have any questions!

Hi Jessica -- I do have questions: 1- Do you have any idea how many patients have had the banding with Dr. Shen? (He hasn't answered me.). 2- Do you know if there are any downsides or adverse events associated with the banding?  3- Did you have any problems or discomfort following the procedures and if yes, how long did they last?

Thank you so much!

Debbie  (UC diagnosis 1997, j-pouch 1998, takedown 1999,  j-pouch redo 2000, takedown 2001)

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