Proctology in Ankara, Turkey

Proctology is the branch of medicine that deals with the diagnosis and treatment of diseases in the rectum and anus (anal) region, which is the final part of the digestive system. Today, this specialty forms the foundation of a much broader discipline known as Colorectal Surgery, which encompasses not only common conditions such as hemorrhoids but also the entire large intestine (colon). The importance of this field stems from its ability to offer modern and effective treatment solutions across a wide spectrum, ranging from benign conditions that directly affect patients’ quality of life to serious health problems such as colon and rectal cancer.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Proctology in Ankara, to get information about Proctology prices, the process, and the hospital where Proctology is performed.

Which Diseases Does the Field of Colorectal Surgery Deal With?

The modern world of colorectal surgery encompasses the entire large intestine, which is the final and critical part of our digestive system. However, this does not mean that we only deal with the inner wall of the intestine. This specialty focuses on the health of an interconnected whole system.

To better understand this wide range of diseases, we can examine them under four main headings.

1. Cancer and Precancerous Lesions (Neoplastic Diseases)

This group constitutes the most serious and vital part of colorectal surgery. Early diagnosis and correct surgery are life-saving in these diseases. The main problems under this heading are as follows:

Colorectal Polyps

Colon Cancer

Rectal Cancer

Anal Cancer

Hereditary Cancer Syndromes (FAP, Lynch Syndrome)

Polyps are small protrusions that are usually benign but carry the risk of turning into cancer over time. Detecting and removing them early through colonoscopy is the most effective way to prevent cancer before it develops. Colon and rectal cancers are common in society and are diseases in which surgical treatment plays the main role. The treatment process is generally planned with a holistic approach by working closely with oncology and radiotherapy specialists.

2. Inflammatory Bowel Diseases and Diverticulitis

Diseases in this group are characterized by chronic inflammation of the intestine and can seriously affect patients’ quality of life. Surgery usually comes into play when medical treatment is insufficient or when life-threatening complications develop.

Ulcerative Colitis

Crohn’s Disease

Diverticular Disease (Diverticulitis)

Ulcerative colitis and Crohn’s disease are autoimmune conditions in which the immune system attacks its own intestinal tissue. In ulcerative colitis, complete recovery can be achieved by surgically removing the entire diseased large intestine. In Crohn’s disease, surgery aims to resolve problems such as obstruction, abscess, or fistula caused by the disease. Diverticulitis is the inflammation of pouches formed in the wall of the large intestine and may sometimes lead to conditions such as perforation that require emergency surgery.

3. Benign Anorectal Diseases

This category includes the most common conditions that come to mind when proctology is mentioned. Although they are not life-threatening, they can turn daily life into a nightmare with severe pain, bleeding, and discomfort. Expertise in this field requires providing effective treatment without damaging the sensitive anatomy. The most common conditions are:

Hemorrhoids (Piles)

Anal Fissure

Anorectal Abscess and Fistula

Pilonidal Sinus

Anal Warts (Condyloma)

4. Functional Disorders and Pelvic Floor Problems

This group is concerned with impairments in function rather than structure. The act of defecation occurs through the coordinated functioning of a complex network of muscles and nerves called the pelvic floor. When this harmony is disrupted, serious problems may arise.

Rectal Prolapse

Fecal Incontinence (Gas and Stool Leakage)

Obstructive Defecation

Rectocele

Chronic Constipation

The solution to these problems aims not only at anatomical repair but also at restoring function. Therefore, this field is an important part of colorectal surgery that requires special expertise and experience.

Which Diagnostic Methods Are Used for Accurate Diagnosis?

The first and most important step of effective treatment is understanding what the problem is. In colorectal surgery, the diagnostic process resembles putting together clues like a detective. Everything starts with what the patient describes and continues with a series of methods extending to the most advanced technological possibilities.

• The Beginning of Everything: Conversation and Examination

Despite all technology, nothing replaces listening to the patient and performing a careful examination. Details such as when your complaints started, the color of your bleeding, and the nature of your pain provide the first and most valuable clues on the path to the correct diagnosis. The physical examination performed following this conversation, and especially the digital rectal examination (DRE), play a critical role in making a preliminary diagnosis of many diseases. This simple examination often prevents unnecessary tests and allows for direct, targeted planning.

• Looking Inside: Endoscopic Methods

Directly visualizing the inner surface of the intestine with a camera is the gold standard in diagnosis. Different endoscopic methods are available for this purpose.

Anoscopy / Rectoscopy: Simple procedures that examine the anal canal and the last part of the rectum and can be easily performed in office settings.

Flexible Sigmoidoscopy: Used to examine the last 60 cm of the large intestine.

Colonoscopy: Examination of the entire large intestine with a flexible tube equipped with a camera at its tip. Colonoscopy not only establishes a diagnosis but also has the invaluable feature of preventing cancer by removing polyps that may turn into cancer before they grow, during the same session. Therefore, it is both a diagnostic and therapeutic method.

• More In-Depth Evaluation: Advanced Imaging

Sometimes endoscopy is not sufficient, and more advanced imaging methods are needed to understand how deep the disease has penetrated the wall or its relationship with surrounding tissues.

Endorectal Ultrasound (ERUS): Used especially in staging rectal cancer. It shows with great precision which layers of the rectal wall the tumor has reached and whether it has spread to nearby lymph nodes. This information is vital in deciding whether additional preoperative treatment (radiotherapy/chemotherapy) is necessary.

Magnetic Resonance Imaging (MRI): Another important method used in staging rectal cancer and evaluating pelvic floor diseases.

Computed Tomography (CT): Used to assess whether cancer has spread to other organs in the abdomen or distant areas.

CT Colonography (Virtual Colonoscopy): An alternative screening method for patients who cannot undergo standard colonoscopy.

• Evaluating Functions: Physiology Tests

In functional problems such as fecal incontinence or severe constipation, it is necessary to determine whether the issue originates from muscle strength, nerves, or sensation. This is where physiology tests come into play.

Anorectal Manometry: A test that measures the resting and squeezing pressures of the anal muscles, the rectum’s capacity to perceive fullness, and reflexes. It provides objective data for proper treatment planning.

Defecography: The examination of the act of defecation by recording it on video under X-ray or MRI. It is highly valuable in revealing the cause of obstructive defecation (for example, rectocele, rectal prolapse).

What Treatment Options Are Available for the Treatment of Diseases?

The treatment philosophy in colorectal surgery is based on a stepwise approach. In every possible case, treatment begins with the simplest and least harmful method to the body. Surgery usually comes into consideration when other methods fail or when it is the only solution due to the nature of the disease.

First Step: Non-Surgical and Office-Based Treatments

Especially in benign anal diseases, treatment generally begins with lifestyle changes. Dietary regulation, increasing fiber intake, and adequate fluid consumption can control the complaints of many patients. When these methods are insufficient, simple and effective interventions that do not require anesthesia can be applied in office or outpatient settings. Some of these are:

• Rubber Band Ligation (for Hemorrhoids)
• Sclerotherapy (for Hemorrhoids)
• Infrared Coagulation (for Hemorrhoids)
• Botulinum Toxin Injection (for Anal Fissure)
• Evacuation of Thrombosed Hemorrhoid
• When Surgery Is Required: Modern Approaches

When surgery is unavoidable, modern techniques prioritize patient comfort, safety, and rapid recovery. Today, two main approaches stand out in colorectal surgery.

Minimally Invasive Surgery (Closed Surgery): This approach includes laparoscopic or robotic surgery. Instead of making a large incision in the abdominal wall, the operation is performed through several small incisions with the help of a camera and special instruments. The main advantages of this method include less postoperative pain, better cosmetic results, shorter hospital stays, and a much faster return to normal activities. Especially in challenging surgeries such as rectal cancer within the pelvis, which is a narrow and deep working area, robotic surgery provides significant benefits in preserving nerves and functions thanks to the three-dimensional visualization and superior maneuverability it offers the surgeon.

Open Surgery: The traditional method of open surgery remains the gold standard and an indispensable technique, especially in emergency situations such as intestinal perforation, very large tumors, or cases with extensive intra-abdominal adhesions due to previous surgeries.

Main Types of Surgery

There are many different surgical procedures applied according to the disease and its location:

• Colectomy: Removal of a diseased portion of the colon.
• Proctectomy: Removal of the rectum.
• Stoma (Bag) Creation: Bringing the intestine to the abdominal wall. It may be temporary or permanent.
• Hemorrhoid Surgeries (Hemorrhoidopexy, Hemorrhoidectomy): Surgical treatment of advanced hemorrhoids.
• Fissure Surgery (Lateral Internal Sphincterotomy): Permanent treatment of chronic anal fissure.
• Fistula Surgeries: Different techniques (Fistulotomy, LIFT, Flap) are used for simple or complex fistulas.
• Rectal Prolapse Repair: Restoring the rectum to its normal position through different surgeries performed abdominally or anally.

What Is the Importance of Colorectal Surgery for Public Health and Quality of Life?

The mission of colorectal surgery extends far beyond treating a single organ or disease. While this specialty plays a key role in protecting public health, it also aims to enhance individuals’ long-term well-being and quality of life by directly impacting their lives.

• The Hidden Hero in the Fight Against Cancer: Prevention

Colorectal cancer is a preventable type of cancer. The most powerful weapon in this fight is screening colonoscopy. A screening colonoscopy performed by a colorectal surgeon not only detects an existing cancer at an early stage. More importantly, it identifies and removes polyps with the potential to turn into cancer in the future, thereby preventing cancer from developing at all. This is literally a life-saving public health service. Therefore, encouraging participation in screening programs and raising public awareness on this issue are among the most important social responsibilities of this specialty.

• Beyond Treatment: Focusing on Quality of Life

In the past, success in surgery was measured by the complete removal of cancer and patient survival. Of course, this is still our most fundamental goal. However, the modern understanding of surgery makes it essential to preserve the patient’s postoperative quality of life at the highest possible level while achieving this goal.

After a major rectal surgery, the patient’s ability to maintain normal bowel control and not experience problems in urinary functions or sexual life is as important a success criterion as the absence of cancer recurrence. For this reason, current surgical techniques focus on details such as nerve-sparing surgery and the creation of new intestinal reservoirs (pouches) aimed at improving function.

In some cases, instead of trying to preserve a severely dysfunctional anus with a very difficult surgery, the option of a well-managed stoma (bag) that can provide a more comfortable life for the patient may offer a better quality of life. The important thing is to honestly discuss all these options for each patient individually and make the decision together with the patient, taking into account their priorities and lifestyle. This is the foundation of a modern and humane approach to medicine that sees the patient not just as a “case” but as a whole person.

Frequently Asked Questions