The Effect of Surgical Treatment on Anal Sphincter Function in Patients with Rectal Prolapse
Languages of publication
The aim of the study was analysis of an anal sphincter function in patients before and after surgery for rectal prolapse.Material and methods. Between 1987 and 2005, 49 patients underwent operations for rectal prolapse. The anal sphincter function was analyzed in 17 of these patients. Abdominal approach surgery was performed in 13 patients; this involved rectopexy in 11 and sigmorectal resection in two others. A transanal approach was chosen in four patients, with the Mikulicz technique in two cases, the Delorme procedure in one, and the Altmeier procedure in the remaining case.Results. In all patients who were operated using the transanal approach, we observed some regression in anal sphincter insufficiency. Among the patients operated using the abdominal approach, first degree incontinence persisted in three cases, second degree in five cases, and third degree persisted in four cases. As a result of the surgical treatment of rectal prolapse by rectopexy and transanal approach, we observed a statistically significant increase in the resting anal sphincter pressure; this increase on average reached 58.8 mm Hg. A statistically significant increase in the average maximum squeeze anal sphincter pressure (95.9 mm Hg) was attained after the surgical procedures were performed on patients with rectal prolapse.Conclusion. The results suggest that the improvement of anal function in the control of stool and flatus after surgical treatment for rectal prolapse appears to be the result of an increase in the rest and maximal squeeze pressures of the anal sphincters.
1 - 2 - 2008
7 - 4 - 2008
- Kościński T: Wypadanie odbytnicy. Wypadanie odbytu. W: Choroby struktur dna miednicy pod red. T. Kościńskiego. Zysk i S-ka. Poznań 2006, 100-34.
- Kupfer CA, Goligher JC: One hundred consecutive cases of complete prolapse of the rectum treated by operation. Br J Surg 1970; 57: 481.
- Penfold JCB, Hawley PR: Experiences of Ivalon sponge implant for complete rectal prolapse at St Marks' hospital 1960-1970. Br J Surg 1972; 59: 846-48.
- Keighley MRB, Fielding JWR: Management of faecal incontinence and results of surgical treatment. Br J Surg 1983; 70: 463-68.[PubMed]
- Spencer JR: Manometric studies in rectal prolapse. Dis Colon Rectum 1984; 27: 523-35.[Crossref][PubMed]
- Metcalf AM, Loening-Baucke V: Anorectal function and defecation dynamics in patients with rectal prolapse. Am J Surg 1988; 155: 206-10.
- Broden G, Dolk A, Holmstrõm B: Recovery of the internal and sphincter following rectopexy: a possible explanation for continence improvement. Int J Col Dis 1988; 3(1): 23-28.[Crossref]
- Poen AC, de Brauw M, Felt-Bersma RJF et al.: Laparoscopic rectopexy for complete rectal prolapse. Clinical outcome and anorectal function test. Surg Endosc 1996; 10(9): 904-08.[WoS][Crossref]
- Delemarre JBVM, Gooszen HG, Kruyt RH et al.: The effect of posterior rectopexy on fecal incontinence. Dis Colon Rectum 1991; 34(4): 311-16.[PubMed][Crossref]
- Araki Y, Isomoto H, Tsuzi Y et al.: Transsacral rectopexy for recurrent complete rectal prolapse. Surg Tod 1999; 29(9): 970-72.[Crossref]
- Huber FT, Stein H, Siewert JR: Functional results after treatment of rectal prolapse with rectopexy and sigmoid resection. W J Surg 1995; 19(1): 138-43.[PubMed]
- Xynos E, Chrysos E, Tsiaoussis J et al.: Resection rectopexy for rectal prolapse. The laparoscopic approach. Surg Endosc 1999; 13(9): 862-64.[PubMed][Crossref]
- Di Giorgio A, Biacchi D, Sibio S et al.: Abdominal rectopexy for complete rectal prolapse: preliminary results of a new technique. Int J Col Dis 2005; 20(2): 180-89.[Crossref]
- Schultz I, Mellgren A, Dolk A et al.: Continence is improved after the ripstein rectopexy. Different mechanisms in rectal prolapse and rectal intussusception? Dis Colon Rectum 1996; 39(3): 300-06.[Crossref]
- Peter Sainio A, Petri E, Husa V et al.: Recovery of anal sphincter function following transabdominal repair of rectal prolapse: Cause of improved continence? Dis Colon Rectum 1991; 34(9): 816-21.[Crossref]
Publication order reference