Purpose: Propiverine hydrochloride (PH) is widely used for the treatment of urinary incontinence (UI) due to bladder overactivity. Moreover, the comorbidity of UI with fecal incontinence (FI) is known to be due to the relationship of both to nervous system disorders and dysfunction or weakening of the pelvic floor muscles. The aim of this single-arm prospective study was to evaluate the therapeutic value of PH for FI.Methods: Patients (n = 24) who were diagnosed as having both FI and UI from April 2015 to November 2016 were included in the study and administered a dosage of 10–20 mg PH every day for 1 month. The primary endpoint was to create a reduction in the frequency of FI per week. An evaluation criterion of ≥50% reduction in frequency was determined as effective. The percentage of the patients who achieved the ≥50% endpoint (responders) was also calculated.Results: The frequency of FI per week was 6.0 ± 8.2 (0.25–30) at baseline and reduced to 1.6 ± 2.1 (0–7) at the posttherapeutic state (P = 0.005). A reduction of ≥50% was seen in 14 of the patients (58.3%).Conclusion: PH reduced the frequency of FI in patients with both FI and UI. This study introduces a possible therapeutic option for the pharmacological treatment of FI.
Purpose: To evaluate the surgical outcomes of transabdominal rectopexy for rectal prolapse. Subjects: 94 cases between 2012 and 2019. Results: 24 patients underwent laparotomy and 70 patients underwent laparoscopy. Mean age was 72.3 years (17-93), with 10 males and 84 females. Mean prolapse length was 4.3 cm (1-10). 55 cases were operated for the first time, and 39 were recurrent cases (8 second recurrence or more). The mean operative time was 148 minutes for open suture fixation, 143 minutes for laparoscopic suture fixation, and 229 minutes for laparoscopic ventral rectopexy. Recurrence was observed in 8 patients (8.5%). In all cases of recurrence with suture rectopexy as the previous treatment, the fixation on the intestinal side had dislocated, suggesting that the intestinal serosal muscle layer at the fixation site had torn due to tissue fragility or a shallow and narrow needle, resulting in recurrence. Conclusion: In transabdominal rectopexy, it is important to pay close attention to tissue fragility of the intestinal tract, especially during suture fixation, to ensure secure fixation.
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