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Surgery for occult rectal prolapse.

A J Brown1, J H Anderson, R F McKee

  • 1Department of Coloproctology, The Royal Infirmary, Glasgow, UK. alistair.brown4@btopenworld.com

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|April 28, 2004
PubMed
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This summary is machine-generated.

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Surgery for occult rectal prolapse shows mixed results. While it improves fecal incontinence for many, it may worsen constipation in some patients. Outcomes are comparable to overt rectal prolapse surgery.

Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Pelvic floor disorders

Background:

  • Occult rectal prolapse diagnosis can be challenging, often identified during investigations for altered bowel habits.
  • Previous suggestions indicate potentially inferior surgical outcomes for occult rectal prolapse compared to overt cases.

Purpose of the Study:

  • To compare surgical outcomes for 'occult' versus overt rectal prolapse.
  • To evaluate differences in mortality, morbidity, and changes in bowel habit post-surgery.

Main Methods:

  • Retrospective review of 143 patients undergoing rectal prolapse surgery (1988-1998).
  • Surgical procedures included resection rectopexy, sutured rectopexy for incontinence, and perineal procedures for unfit patients.
  • Outcome measures encompassed mortality, morbidity, prolapse recurrence, constipation, and fecal incontinence.

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Main Results:

  • No 28-day mortality; major complications in 3.5% of patients. Recurrence observed in 10%.
  • Surgery significantly reduced fecal incontinence in both overt (38% to 19%) and occult (49% to 22%) prolapse groups.
  • Constipation increased post-surgery in the occult group (39% to 50%) but decreased in the overt group (42% to 35%).

Conclusions:

  • Surgical intervention for occult rectal prolapse may not benefit patients primarily experiencing constipation.
  • Approximately 50% of patients with occult rectal prolapse and fecal incontinence experience improved bowel habits after surgery.