One hundred consecutive cases of complete prolapse of the rectum treated by operation

Abstract

One hundred patients, 17 male and 83 female, ranging in age from a few days to 97 years , have been treated between 1955 and 1969 for complete prolapse of the rectum.2. One hundred and twelve operations were performed, 91 by the abdominal route, mostly Roscoe Graham repairs or Ivalon sponge implants, with only 2 immediate deaths.3. The late results were assessed usually by interview and physical examination 6 months to 14 years (mean 5 years 5 months) postoperatively. Seventyfive of the patients who had had abdominal operations were available for such assessment; 5, or 6.6 per cent, were found to have recurrent complete prolapses (and I I mucosal recurrences of doubtful significance). Anal incontinence, so frequently associated with rectal prolapse, was improved in some of the patients after abdominal repair, but in roughly half the patients there was no improvement and in I case anal control apparently deteriorated after operation.FROM March, 1955, to December, 1969, IOO patients with complete prolapse of the rectum were seen and treated by the senior author (J. C. G.) at the General Infirmary, Leeds. We have recently conducted a survey of these patients, the main aim of which was to assess the value of modern surgical treatment for this condition. AGE AND SEX INCIDENCEOf the IOO patients 17 were male and 83 female, a ratio of approximately I : 5. The age incidence at the time of operation is shown in Fig. I. The youngest patient was a baby a few days old, the oldest a woman 34 of 97 years. It is remarkable that the proportion of male patients was roughly equal throughout the different decades whilst only some 20 per cent of the female patients presented before the age of 50, the maximum incidence of 22 patients or 25 per cent being reached in the seventh decade. No. of Patients PREDISPOSING FACTORSThough in general the cause of complete rectal prolapse is not understood, in some cases associated circumstances are present which may be aetiologically important. Thus no less than 4 of the IOO patients

Rare case of huge rectal and uterovaginal prolapse

“…Rarely uterine prolapse can be manifested along with rectal prolapse. 2,7,8 Prolapse refers to "the falling down or slipping of a body part from its usual position or relations". It is derived from the Latin pro--"forward" + labi -"to slide".…”

“…[5][6][7] Vaginal hysterectomy with pelvic floor repair, followed by repair of rectal prolapse by Delorme method is a best approach.…”

Surgery for Complete Rectal Prolapse: A Simplified Approach

“…Efficacy of simple suture rectopexy is time tested with recurrence rate varying from 4-10% [9]. Experience of various operators on reexploration of pelvis after low anterior resection revealed that dense post operative fibrosis fixes rectum to the sacral hollow [2].…”

“…Placement of sutures between bladder base and anterior rectal wall provides additional support and prevents initiation of sliding herniation of anterior rectal wall which later develops into full procendentia [9]. Limited 3 inch approx.…”

43. Prolaps und Sphincterinsuffizienz

“…Wohl ist auch hier die Diagnose durch den Nachwcis prolabicrcnder zirkul~rer Schleimhautfaltcn, mindcstens bcim PrcBakt, vSllig klar. Dieser Befund stellt aber bereits das Endstadium einer mehr oder weniger protrahierten Entwicklung dar; FremdkSrpergeffihl oder Druck im Rectum, das Geffihl der unvollst/~ndigen Entlecrung verbunden mit Tencsmcn oder schlieBlich einmal Schleim-und Blutabg/inge infolge Irritation der Schlcimhaut sind unspezifische Friihsymptome [3,17,23]. Die chronischc…”