Internal rectal intussusception seldom develops into total rectal prolapse

Mellgren, Anders; Schultz, Inkeri; Johansson, Claes; Dolk, Anders

doi:10.1007/bf02055439

Cited by 99 publications

(45 citation statements)

References 25 publications

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“…This was a deliberate choice, since rectopexy does not provide convincing results in incomplete rectal prolapse [6]. Moreover, incomplete prolapse does not evolve into true prolapse [28]. Perineal procedures were not undertaken in our department because of insufficient documentation on the long-term results [1,19], despite the fact that it is a benign [34] and effective procedure in good hands [2].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic rectopexy according to Wells

et al. 1999

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Section: Discussionmentioning

confidence: 99%

Laparoscopic rectopexy according to Wells

et al. 1999

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“…At clinical gynecologic examination, including Valsalva maneuver, rectal prolapse was not detected in either of the two patients with demonstrable rectal prolapse at CDP. Rectal prolapse necessitates surgical treatment, while conservative treatment is usually preferred for rectal intussusception [26]. Even though surgical intervention may not always be suitable for anatomic defects, some patients may still benefit from an investigation explaining the cause of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography

et al. 2004

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The aim of the present study was to compare clinical and radiological findings when assessing posterior vaginal wall prolapse. Defecography can be used to complement the clinical evaluation in patients with posterior vaginal wall prolapse. Further development of the defecography technique, using contrast medium in the urinary bladder and intraperitoneally, have resulted in cystodefecoperitoneography (CDP). Thirty-eight women underwent clinical examination using the pelvic organ prolapse quantification system (POP-Q) followed by CDP. All patients answered a standardized bowel function questionnaire. Statistical analysis measuring correlation between POP-Q and CDP using Pearson's correlation coefficient (r) and Spearman's rank order correlation coefficient (rs) demonstrated a poor to moderate correlation, r=0.49 and rs=0.55. Although there was a strong association between large rectoceles (>3 cm) at CDP and symptoms of rectal emptying difficulties (p<0.001), severity and prevalence of bowel dysfunction showed poor coherence with clinical prolapse staging and findings at radiological imaging. Vaginal topography and POP-Q staging predict neither radiological size nor visceral involvement in posterior vaginal wall prolapse. Radiological evaluation may therefore be a useful complement in selected patients.

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“…Adequate treatment of rectal prolapse and frequently associated pelvic floor disorders are controversially discussed [1,3,4,5,6,7]. Within the last decades, numerous techniques have been developed and modified in order for rectal prolapse to be treated (Table 1).…”

Section: Rectal Prolapse: What Surgical Therapy Is Appropriate?mentioning

confidence: 99%

Rectal prolapse: which surgical option is appropriate?

Schiedeck¹,

Schwandner²,

Scheele³

et al. 2004

Langenbecks Arch Surg

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Numerous surgical procedures have been suggested to treat rectal prolapse. In elderly and high-risk patients, perineal approaches such as Delorme's procedure and perineal rectosigmoidectomy (Altemeier's procedure) have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Functional results of transabdominal procedures, including mesh or suture rectopexy and resection-rectopexy, are thought to be associated with low recurrence rates and improved continence. Transabdominal procedures, however, usually imply rectal mobilization and fixation, colonic resection, or both, and some concern is voiced that morbidity, in terms of infection or leakage, and mortality could be increased. If we focus on surgical outcome, our own experience of laparoscopic resection-rectopexy for rectal prolapse shows that the laparoscopic approach is safe and effective, and functional results with respect to recurrence are favorable. However, the controversy "which operation is appropriate?" cannot be answered definitely, as a clear definition of rectal prolapse, the extent of a standardized diagnostic assessment, and the type of surgical procedure have not been identified in published series. Randomized trials are needed to improve the evidence with which the optimal surgical treatment of rectal prolapse can be defined.

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Internal rectal intussusception seldom develops into total rectal prolapse

Abstract: The present study demonstrates that the risk of developing a rectal prolapse in patients with rectal intussusception is small. This risk should, therefore, not be used as an indication for surgery.

Cited by 99 publications

References 25 publications

Laparoscopic rectopexy according to Wells

Laparoscopic rectopexy according to Wells

Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography

Rectal prolapse: which surgical option is appropriate?

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