Prospective study of the effect of rectopexy on colonic motility in patients with rectal prolapse

Abstract

Patients with rectal prolapse have abnormal colonic motility associated with reduced HAPC activity. Rectopexy reduces colonic pressure but fails to restore HAPCs, reduce constipation or improve colonic transit. These observations help explain the pathophysiology of constipation associated with rectal prolapse.

Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation

“…At least 50% of patients with rectal prolapse are constipated before surgery [10,12–14]. Pre‐existing hindgut neural abnormalities, postulated to be a traction injury from the loss of rectal support, disappear following correction of the prolapse, as do the reduced anal canal pressures and evidence of pelvic floor neuropathy [15]. There is no doubt that classical posterior rectopexy corrects constipation in some patients by stopping the rectum intussuscepting [3].…”

Laparoscopic Ventral Rectopexy for Fecal Incontinence Associated with High-Grade Internal Rectal Prolapse

“…[3][4][5] internal rectal prolapse, also referred to as rectal intussusception, is considered by some to be a precursor of external rectal prolapse, but its role in continence disturbance remains unclear. 2 a number of studies have outlined that correction of the prolapse by rectopexy reduces rectal pressure and improves continence in 45% of patients.…”

Laparoscopic Rectopexy without Resection: A Worthwhile Treatment for Rectal Prolapse in Patients without Prior Constipation

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] This is true whether the operation includes mesh rectopexy, 2, 9-11 suture rectopexy, 13,14 or resection combined with rectopexy. 1, 3-8, 11, 12 Some reports suggest that rectopexy without resection worsens constipation and bowel evacuation; 6,9,15 however, this observation has not been universally noted by investigators. In fact, improvements in constipation-related symptoms have been noted in studies in which rectopexy alone was performed.…”