Background: Rectal procidentia (rectal prolapse) is a disabling condition. Surgical repair is the treatment of choice for candidates who have a full thickness rectal procidentia. Multiple procedures exist for the repair of rectal procidentia, however; none of them is most effective. Methods: This study was carried out at Minia University Hospital as a prospective non randomized study that compared laparoscopic posterior mesh rectopexy (Group A; n = 20) with Recto-sigmoidectomy (Group B; n = 20) for complete rectal prolapse as regards complications; functional outcomes (constipation and continence) and sexual functions after surgery. Results: The female to male ratio was 3: 2 and their ages ranged from 19-70 years with mean of 41.2 years. The operative time in the resection rectopexy group was significantly longer than the rectopexy group. No significant difference between the two groups regarding intraoperative complications (bleeding only). Resection rectopexy group had statistically significant drop in the constipation score than Posterior mesh rectopexy group with a mean score of 16.9 point(pre) and 2.3point(post) versus a score of 10.3point(pre) and 4.3point(post) respectively. There is no incontinence occurred in mesh rectopexy group but in resection rectopexy group; there were 6 patients developed incontinence with a range 0-20 point and mean 5.4 point The P-Value was 0.007 and it is statistically significant. Sexual functions are preserved in both groups. Conclusion: Although recto-sigmoidectomy seems to affect the continence, it improves constipation scores more significantly in patients with chronic constipation than the posterior mesh rectopexy. Sexual functions will be preserved in both operations.
Aim: Test the effectiveness and results of anal sphincter repair and the effect of different factors on the outcomes of the operation. Patients and methods: In the period between January 2017 and January 2020; thirty Patients who had fecal incontinence and who presented to Minia University hospital underwent anal sphincter repair. Data on demographic information, etiology, duration of symptoms before surgery, imaging data, type of procedure performed, complications, and outcomes were collected. The participants were followed-up for a minimum of 6 months following anal sphincter repair. Patients were classified according to their satisfaction from surgery into two groups; well satisfied and not satisfied patients. They were classified according to the degree of continence after surgery into full; partial and non-continent patients. Results: 83.3% of patients were satisfied after surgery versus 16.7% who were unsatisfied. About seventy-three percent (73.3%) of the 30 patients stated subjectively that they had become fully continent after the repair, however, 8 patients (26.7%) became partially continent. Conclusion: Sphincter repair operation is a safe and feasible operation for the treatment of fecal incontinence due to different causes. Sphincter injuries due to road traffic accidents are associated with best outcomes while iatrogenic injuries have the worst outcomes. Better results are obtained with external sphincter repair versus the isolated internal sphincter repair. It seems that age and duration after surgery don't affect the outcomes.
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