Results of treatment for rectal prolapse and fecal incontinence

Abstract

Fifty-six patients were treated for rectal prolapse or incontinence. Rectal prolapse was present in 32 patients and was associated with fecal incontinence in 24 (75 per cent). Incontinence without prolapse was present in 24 patients, 12 of whom were less than 40 years old. Rectopexy was used for treatment of rectal prolapse. Surgical treatment of fecal incontinence was by postanal repair; external sphincter reconstruction and surgery was advised only if control of diarrhea and electrical therapy had been of no benefit. Rectopexy was completely successful at controlling rectal prolapse in all cases, and only four of the 20 (20 per cent) patients with incontinence and prolapse remained incontinent after rectopexy alone. Incontinence was completely controlled by postanal repair in 58 per cent of patients and by external sphincter repair alone or in combination with postanal repair in 67 per cent. Using a combination of therapies 45 of 48 patients who were initially incontinent were improved (94 per cent), and 42 of the patients have complete control of defecation (87 per cent).

Laparoscopic rectopexy according to Wells

“…The only patient who remained incontinent did not show any anomanometric changes, as would be expected [11,18]. Abdominal rectopexy is indeed a superior technique in dealing with the incontinence problem [23]. Our (and the patients) major disappointment with the technique, however, was the high incidence of postoperative constipation (38% of the patients we were able to follow), as documented radiologically by a transit time of >3 days.…”

Klinische und funktionelle Ergebnisse der abdominalen Rektopexie unter Verwendung verschiedener Fixierungsgrundlagen

“…Die verbliebene oder neu aufgetretene Inkonintenz nach einer Rektopexie wird verschiedenen Einflfissen zugeordnet, wie der Anamnesedauer [8], mehrfachen Geburten [12] einem Analprolaps [15,27], einer f~berdehnung des N. pudendus mit einer Denervierung des M. puborectalis [37,39], einem schwachen Internustonus [9] oder einer Aufhebung des anorektalen Winkels [1]; unsere Ergebnisse stfitzen die ersten beiden Erfahrungen nicht. Die Therapie der persistierenden Inkontinenz nach einer Rektopexie dutch die perineale posteriore Levatorplastik nach Parks [38] ergab, auch nach eigener Erfahrung, Verbesserungen in bis zu 80% der wenigen operierten F/ille [24].…”

Comparative study of rubber band ligation versus surgical excision in the treatment of second-degree haemorrhoids

“…Patients admitted with second-degree haemorrhoids were included in the study, ensuring a homogeneous representation of the target population [10]. The age range considered for inclusion was 18 years and beyond, covering a broad spectrum of adults affected by this prevalent condition [3].…”