Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram

Farouk, Ridzuan; Duthie, G. S.; Bartolo, D. C. C.; MacGregor, A. B.

doi:10.1002/bjs.1800790523

Cited by 99 publications

(49 citation statements)

References 8 publications

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“…The fact that the internal sphincter plays an important role in continence in rectal prolapse is shown by the significant improvement in internal anal sphincter electromyographic frequency and mean resting pressure after successful continence-correcting surgery [7,9,12,20]. It has also been suggested that the external sphincter component plays an important role in incontinence [7,9,12,20,22,29].…”

Section: Continencementioning

confidence: 98%

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Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients

2006

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Section: Continencementioning

confidence: 98%

“…It has also been suggested that the external sphincter component plays an important role in incontinence [7,9,12,20,22,29]. Duthie and Bartolo [6] suggested that the repair of rectal prolapse improves the anorectal sensation and therefore continence.…”

Section: Continencementioning

confidence: 99%

Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients

2006

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“…However, up to 40% of patients with an ileoanal pouch experience periodic, often nocturnal fecal incontinence, possibly related to uncoordinated pouch contractions (48). Similarly, rectal prolapse may be associated with fecal incontinence in up to 88% of cases (49)(50)(51). This is most likely due to prolonged inhibition of anal tone from intussusception of the rectum into the upper anal canal.…”

Section: Pathogenic Mechanisms and Etiologymentioning

confidence: 99%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

286

295

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DEFINITIONFecal incontinence is defined as either the involuntary passage or the inability to control the discharge of fecal matter through the anus. Clinically there are three subtypes (a) passive incontinence-the involuntary discharge of stool or gas without awareness; (b) urge incontinence-the discharge of fecal matter in spite of active attempts to retain bowel contents, and (c) fecal seepage-the leakage of stool following otherwise normal evacuation. The severity of incontinence can range from the unintentional elimination of flatus to the seepage of liquid fecal matter or sometimes the complete evacuation of bowel contents. Not surprisingly, these events cause considerable embarrassment, which in turn can lead to a loss of self-esteem, social isolation, and a diminished quality of life (1). EPIDEMIOLOGYAlthough fecal incontinence affects people of all ages, its prevalence is disproportionally higher in women, in the elderly, and in nursing home residents. Estimates of its prevalence vary greatly and depend on the clinical setting, the influence of social stigma, the definition of incontinence, and the frequency of occurrence.In the U.S. householder survey, frequent leakage of stool or fecal staining for more than 1 month was reported by 7.1% and 0.7% of the population, respectively (2). In contrast, two or more episodes of fecal incontinence per month were reported by 0.8% of patients presenting to primary care clinics in the UK (3). In an elderly (>65 yr) self-caring population, fecal incontinence occurred at least once a week in 3.7% of subjects and in more men than women (men:women = 1.5:1) (4). In contrast, 25-35% of institutionalized patients (5) and 10-25% of hospitalized geriatric patients (6) suffer from fecal incontinence. In the United States, fecal incontinence is the second leading cause for placement in nursing homes (6).In a survey of 2,570 households, comprising 6,959 individuals, the prevalence of at least one episode of incontinence during the previous year was 2.2%; among these 63% were women, 30% were >65 yr of age, 36% were incontinent of solid stool, 54% of liquid stool, and 60% of flatus (7). Furthermore, in another prospective survey of patients attending either a gastroenterology or a primary care clinic, over 18% reported fecal incontinence at least once a week (8). Only one third had ever discussed the problem with a physician (8). When stratified for the frequency of episodes, 2.7% of patients reported daily incontinence, 4.5% weekly, and 7.1% once per month (8). In another survey, fecal incontinence was associated with urinary incontinence in 26% of women attending a Uro/Gyn Clinic (9). A higher incidence of mixed fecal and urinary incontinence was also reported in nursing home residents (10, 11).The cost of health care related to fecal incontinence includes items that can be measured such as the evaluation, diagnosis and treatment of incontinence, medications, the use of disposable pads and other ancillary devices, skin care, and nursing care. Approximately $400 million/year we...

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“…As couldb ee xpected, anal incontinence strongly improved (table 4) by removal of the prolapse �hich eliminates dilatation of the anal sphincter muscles. Recoveryo ft he internal anal sphincter as evaluated by electromyogram and anal manometry,h as been demonstrated after rectopexyfor rectal prolapse (18,19). Anal incontinence still continued to improve from first to second evaluation.…”

Section: Discussio�mentioning

confidence: 99%

Resection Rectopexy for External Rectal Prolapse Reduces Constipation and Anal Incontinence

et al. 2007

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Backgroundand Aims: the main aim was to examineconstipation and anal incontinence in patients before and after resection for external rectal prolapse.Material andMethods: twenty patients hadligamentpreservingsuturerectopexy and sigmoid resection (resection rectopexy) for external rectal prolapse by laparoscopic (n =15) or open (n =5)technique during 2001-2005. they were prospectively evaluated for constipationa nd anal incontinence using validated incontinence and Kess-constipation scores.Resultsand Conclusions: Constipation score was significantly reduced from mean 7.7 (5.4-9.9) to 4.5 (2.5-6.4) after median 4months (1-19) and to 4.3 (2.2-6.3) after median 17 months (4-51).S ix and four patients were constipated preoperatively and 17 months postoperatively,respectively.the four symptoms feeling incomplete evacuation of stool, minutes in lavatory per attempt, use of enemas/digitation and painful evacuation effort were significantly reduced, whilsts tool consistency increased. Fourteen patiens (70%) had anal incontinence. Corresponding and significant reductionintheir scores were from mean 12.5 (9.4-15.5) to 5.1 (2.1-8.1) and to 3.6 (1.3-5.9). incontinence was improved in 13 and unaltered in one patient(s). twop atients with worse outcome had increased stool consistency and constipation scores. Resection rectopexy for rectal prolapse reduced anal incontinenceand constipation.

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Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram

Cited by 99 publications

References 8 publications

Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients

Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients

Diagnosis and Management of Fecal Incontinence

Resection Rectopexy for External Rectal Prolapse Reduces Constipation and Anal Incontinence

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