Physiological Study and Roles of Surgical Management in Patient with Rectal Prolapse

Abstract

The clinical and manometric features and surgical course of thirty patients with rectal prolapse treated by polyvinyl sponge rectopexy were reviewed. The female : male ratio was 14 : 1 ; the highest incidence is in the sixth and seventh dexades. Twenty patients had associated anorectal incontinence. 50% of the women had previous hysterectomy and / or pelvic floor repair for uterine prolapse and five women had urinary incontinence. More than 30% of the patients had a significant history of mental illness. Ten patients had previously had fourteen other surgical procedures for rectal prolapse. Five patients required further surgery, three by postanal repair. Maximum resting and squeeze anal canal pressures were signigicantly reduced only in rectal prolapse associated with anorectal incontinence.

Treatment by minor surgical procedures in the elderly and psychiatric patients leads to high reoperation rates. Prior manometric and electrophysiological assessment of the pelvic floor may further improve their management and clinical outcome.