Rectal Prolapse in Young Women

• Authors: Bartosz Wnęk , Krystian Waraczewski , Michał Chalcarz , Agnieszka Kędzia , Aleksandra Łożyńska-Nelke , Paulina Hołodyńska
• Languages of publication: EN

Abstracts

EN

Rectal prolapse belongs to the group of rare diseases of the rectum and anus. It is mostly observed in elderly multiparous women in the seventh and eighth decade. The precise cause of this pathology is not thoroughly understood that is why there are no optimal standards of treatment. The aim of the study was to present pathophysiology, diagnostics and optimal surgical procedures employed in young patients with rectal prolapse. Material and methods. Out of a 56-patient group treated in Department of General and Colorectal Surgery in the years 2006-2011 a smaller one consisting of 11 young women between the ages 20-40 was selected. According to the literature this is a very rare time of the mentioned pathology occurrence. In the studied females grade of rectal prolapse as well as faecal incontinence based on Jorge-Wexner’s (Cleveland) scale were assessed before and after the operative treatment. All of them underwent transabdominal Wells and Frikman-Goldberg prolapse procedures. Results. Transabdominal approaches repair pathologies of the pelvic floor and have promising longstanding results improving quality of life. No rectal prolapse recurrences were observed. The mean score of the Wexner’s grading system was 7.81 diminishing to 1.9 points postoperatively. Conclusions. Rectal prolapse if untreated, is a pathology that substantially changes patients’ quality of life for the worse. Individual, standardized surgical approach to each patient is necessary. Transabdominal methods carry a low risk of complications and improve quality of life of young patients enabling a relatively quick return to normal life

Keywords

EN

rectal prolapse; transabdominal procedures; young women

• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 8
• Pages: 438-445

Dates

published

1 - 08 - 2013

online

05 - 09 - 2013

Contributors

author

Bartosz Wnęk

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań,

author

Krystian Waraczewski

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań

author

Michał Chalcarz

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań

author

Agnieszka Kędzia

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań

author

Aleksandra Łożyńska-Nelke

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań

author

Paulina Hołodyńska

• Department of General and Colorectal Surgery K. Marcinkowski, Medical University in Poznań

References

• 1. Trompetto M, CornagliaS: ThePerineal Approach to Rectal Prolapse. Pelvic Floor Disorders 2010; 48: 509-14.
• 2. Schiedeck THK , Schwandner O, Scheele J et al.: Rectal prolapse: which surgical option is appropriate. Langenbecks Arch Surg 2005; 390: 8-14
• 3. Boutsis C, Ellis H: The Ivalon-sponge-wrap operation for rectal prolapse: an experience with 26 patients. Dis Colon Rectum 1974; 17: 21-37.[Crossref][PubMed]
• 4. Sthela M. Murad-Regadas MD , Rodrigo A et al.: The Abdominal Approach to Rectal Prolapse. PelvicFloor Disorders 2010; 497-508.
• 5. Moody RL : Rectal prolapse. In: Morson BC (red) Diseases of the colon, rectum and anus. Appleton- Century-Crofts: New York, 1969; 238-50.
• 6. Mikulicz-Radecki J: Zuroperativenbehandlung des prolapsus recti et coli invaginati. Arch KlinChir 1889; 38: 74-97.
• 7. Lockhart-Mummery JP: A new operation for prolapse of the rectum. Lancet 1910; 1: 641.[Crossref]
• 8. Moschcowitz AV: The pathogenesis, anatomy and cure of prolapse of the rectum. Surg Gynecol Obstet 1912; 15: 7-21.
• 9. Denet CH : Solitary rectal ulcer syndrome. (In:. Godeberge P (ed.) Anorectal diseases. Medicine- Sciences Flammarion Paris 2008: 152-54.
• 10. Kairaluoma MV, Kellokumpu IH et al.: Epidemiologic aspects of complete rectal prolapse. ScandJ Surg 2005; 3: 207-10.
• 11. Hoel AT, Skarstein A, Ovrebo KK et al.: Prolapse of the rectum, long-term results of surgical treatment. Int J Colorectal Dis 2009; 24: 201-07.[Crossref][PubMed][WoS]
• 12. Nicholls RJ: Rectal prolapse and the solitary ulcer syndrome. Ann Ital Chir 1994; 65: 157-62.[PubMed]
• 13. Roig JV, Buch E, Alós R et al.: Anorectal function in patients with complete rectal prolapse: differences between continent and incontinent individuals. RevEsp Enferm Dig 1998; 90: 794- 805.
• 14. Yoshioka K, Hyland G, Keighley MR B et al.: Anorectal function after abdominal rectopexy: parameters of predictive value in identifying return of continence. Br J Surg 1989; 76: 64-68
• 15. Broden G, Dolk A, Holmsrom B et al.: Evacuation difficulties and other characteristics of rectal function associated with procidentia and the Ripstein operation. Dis Colon Rectum 1988; 31: 233-36.
• 16. Sayfan J, Pinho M, Williams JA et al.: Sutured posterior abdominal rectopexy with sigmoidectomy compared with marlexrectopexy for rectal prolapse. Br J Surg 1990; 77: 143-45.
• 17. Shafik A: Role of pudendal canal syndrome in the aetiology of faecal incontinence in rectal prolapse. Digestion 1997; 58: 489-93.[Crossref]
• 18. Monro A: The morbid anatomy of the human gullet, stomach,and intestines. Archibald Constable & Co, Edinburgh 1811; 363.
• 19. Broden B, Snellman B: Procidentia of the rectum studied with cineradiography. Dis Colon Rectum 1968; 11: 330-47.[PubMed][Crossref]
• 20. Parks AG, Swash M, Urich H: Sphincter denervation in anorectal incontinence and rectal prolapse. Gut 1977; 18: 656-65.[Crossref][PubMed]
• 21. Kuijpers HC : Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect? World J Surg 1992; 16: 826-30.[Crossref][PubMed]
• 22. Agachan F, Chen T, Pfeifer J et al.: A constipation scoring system to simplify evaluation and management of constipated patients. Diseases ofthe Colon & Rectum 1996; 39: 681-85.
• 23. Wells C: New operation for rectal prolapse. ProcR Soc Med 1959; 52: 602-03.
• 24. Novell JR, Osborne MJ, Winslet MC et al.: Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full thickness rectal prolapse. Br J Surg 1994; 81: 904-22.
• 25. Frykman HM : Abdominal proctopexy and primary sigmoid resection for rectal procidentia. AmJ Surg 1955; 90: 780-89.
• 26. Huber FT , Stein H, Siewert JR et al.: Functional results after treatment of rectal prolapse with rectopexy and sigmoid resection. World J Surg 1995; 19: 138-43.[Crossref][PubMed]
• 27. Duthie GS, Bartolo DC : Abdominal rectopexy for rectal prolaps: a comparison of trchniques. BrJ Surg 1992; 79: 107-13.[Crossref]
• 28. Winde G, Reers B, Nottberg H et al.: Clinical and functional results of abdominal rectopexy with absorbable mesh graft for treatment of complete rectal prolapse. Eur J Surg 1993; 159: 301-05.[PubMed]
• 29. Schultz I, Mellgren A, Dolk A et al.: Long-term results and functional outcome after Ripstein rectopexy. Dis Colon Rectum 2000; 43: 35-43.[PubMed][Crossref]

Identifiers

DOI

10.2478/pjs-2013-0067