Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception

Tsunoda, Akira; Takahashi, Tomoko; Ohta, Takao; Fujii, Wataru; Kiyasu, Yoshiyuki; Kusanagi, Hiroshi

doi:10.1007/s10151-015-1423-1

Cited by 9 publications

(3 citation statements)

References 24 publications

(31 reference statements)

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“…First, this was a small retrospective study. Second, as previously shown 18) , pelvic floor descent or anterior intussusception descent may have an additional effect on the appearance of FI. Third, other factors, such as health status and physical limitations 32) , which have been verified to be accompanied with FI, were not evaluated in this study.…”

Section: Discussionmentioning

confidence: 69%

“…Other researchers also supported this theory 16,17) . Our recent study showed that the severity of FI may be affected by anterior intussusception descent, which could trigger the RAIR in patients with RAI 18) . It is possible that the higher intra-abdominal pressure created during daily life may expose the anterior part of the rectal wall to forces consistent with the development of anterior or circumferential RAI and may, thus, trigger the RAIR.…”

Section: Discussionmentioning

confidence: 98%

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Rectoanal intussusception is very common in patients with fecal incontinence

Yagi

Tsunoda

Takahashi

et al. 2018

J Anus Rectum Colon

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Objectives: Fecal incontinence (FI) is a multifactorial disorder, the etiology of which is not fully understood. Recent data have shown the significance of rectoanal intussusception (RAI) in the evaluation of FI. The present study aimed to determine the incidence of RAI in patients with FI. Methods: Between June 2010 and February 2016, 74 patients, who were evaluated using evacuation proctography, anorectal manometry, ultrasound, and incontinence scores, were included in this study. RAI was diagnosed when the apex of the rectal intussusception (RI) impinged on the internal anal orifice or was intra-anal, based on the images taken during maximal straining defecation at evacuation proctography. The characteristics of RAI patients were further analyzed. Results: There were 59 women (80%) and 15 men, with a median age of 74 (52-93) years. Sixty patients (81%) had RI, and 56 (76%) showed RAI. The incidence of RAI among the 32 patients with FI alone and the 42 patients with FI and symptoms of obstructed defecation (OD) was 72% (23/32) and 79% (33/42), respectively. The incidence of RAI was not significantly different between the patients with normal manometry (maximum resting pressure [MRP] ! 55 cmH2O and maximum squeeze pressure [MSP] ! 150 cmH2O, n=26) and those with subnormal manometry (MRP <55 cmH2O and/or MSP <150 cmH2O, n=48). Conclusion: RAI is common in patients with FI. Evacuation proctography should be taken into account as a part of the regular study of FI patients.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 98%

Rectoanal intussusception is very common in patients with fecal incontinence

Yagi

Tsunoda

Takahashi

et al. 2018

J Anus Rectum Colon

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“…A recent study showed that the anterior intussusception descent was significantly greater in level II than level I RAI 16) . Pelvic floor descent was significantly smaller in patients with anterior RAI than those with circular RAI, mainly because the ratio of male to female was relative high in the former (0.7 vs. 0.3).…”

Section: Discussionmentioning

confidence: 94%

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Tsunoda

Takahashi

Hayashi

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: Rectoanal intussusception (RAI) is a common finding on defecography in patients with defecation disorders. This study aimed to compare the proctographic findings and symptoms between patients with anterior RAI and those with circular RAI. Methods: We included 208 patients who were diagnosed as having RAI on defecography. Anorectal function was evaluated using Constipation Scoring System (CSS) and Fecal Incontinence Severity Index (FISI). Results: Twenty-four patients had anterior RAI and 184 had circular RAI. While the anterior intussusception descent or pelvic floor descent was significantly smaller in patients with anterior RAI than those with circular RAI [14.3 vs. 18.5 mm, p=0.004; 12.4 vs. 21.6 mm, p= 0.005], there were no significant differences in incidences of obstructed defecation (OD) and fecal incontinence (FI) between the groups. Sixteen patients with anterior RAI and 137 patients with circular RAI had OD. There was no significant difference in the CSS scores between the groups. Twelve patients with anterior RAI and 108 patients with circular RAI had FI. No significant difference in the FISI scores between the groups. Conclusions: Approximately one tenth of the whole RAI was anterior in location, and symptoms in patients with anterior RAI were similar to those with circular RAI.

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Laparoscopic ventral rectopexy in patients with fecal incontinence associated with rectoanal intussusception: prospective evaluation of clinical, physiological and morphological changes

et al. 2018

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Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception

Abstract: The severity of FI may be affected by anterior intussusception descent in patients with RAI.

Cited by 9 publications

References 24 publications

Rectoanal intussusception is very common in patients with fecal incontinence

Rectoanal intussusception is very common in patients with fecal incontinence

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Laparoscopic ventral rectopexy in patients with fecal incontinence associated with rectoanal intussusception: prospective evaluation of clinical, physiological and morphological changes

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