Xenogeneic collagen has been demonstrated to aid soft tissue reinforcement. In this study, in contrast to published data relating to the use of conventional synthetic mesh, there were no complications related to infection or the implant's proximity to the bowel. This trial demonstrates that the implant is safe, feasible to use and has the potential to prevent parastomal herniation.

EP remains the first line investigation for the diagnosis of rectal intussusception, but may not distinguish mucosal from full-thickness descent. MR defaecography further complements EP by giving information on movements of the whole pelvic floor, 30% of the patients studied having associated abnormal anterior and/or middle pelvic organ descent. If surgery is planned for patients with rectal intussusception, MR defaecography provides useful information regarding the presence and degree of anterior pelvic compartment descent that may need to be addressed if a good functional outcome is to be achieved.

The collagen implant demonstrated excellent biocompatibility and resistance to degradation in most patients. However, fibrovascular in-growth and ECM deposition were limited. This implant has excellent potential for soft tissue reinforcement.

SMART is a new and simple technique of precisely creating a reinforced stoma trephine at both open and laparoscopic surgery. It obviates the technical disadvantages of traditional stoma formation. This pilot study, in a selected group of patients at high risk for parastomal herniation, indicates that the procedure is clinically safe but randomised controlled trials are required to determine its efficacy in reducing parastomal herniation in all patients undergoing elective stoma formation.

The effects of sphincter-saving resections for carcinoma of the rectum on bladder function were studied prospectively. Twenty-seven patients, each acting as his or her own control, were studied before, shortly after and 9 months after operation by means of pressure/flow filling and voiding cystometry. After operation there was a significant and lasting increase in the residual volume of urine and a temporary decrease in the compliance of the bladder. There was a statistically significant decrease in detrusor contraction pressure after operation, which persisted throughout the period of study. This was probably due to partial denervation of the bladder. Four patients had signs of total or almost total denervation of the bladder. There was a significant correlation between proximity of the tumour to the anal verge and risk of damage to the nerve supply to the bladder. Thus sphincter-saving resections of the rectum for carcinoma are associated with a significant risk of bladder denervation. Many of the "minor" symptoms of bladder dysfunction which develop after this procedure are due to partial denervation of the bladder.