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Association between rectocele and paradoxical sphincter response.

C Johansson¹, B Y Nilsson, B Holmström

¹Department of Surgery, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.

Diseases of the Colon and Rectum

|May 1, 1992

Summary

Rectocele and paradoxical sphincter reactions often cause rectal emptying difficulties. Preoperative evaluation is crucial for successful surgical treatment of rectocele in patients with these complex issues.

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Area of Science:

Gastroenterology
Colorectal Surgery
Pelvic Floor Disorders

Background:

Rectocele and paradoxical sphincter reactions are common causes of rectal emptying difficulties and outlet obstruction.
Surgical outcomes for rectocele can be unsatisfactory due to multifactorial causes of emptying disturbances.

Purpose of the Study:

To investigate the prevalence of paradoxical sphincter reactions and colon transit time in patients with rectocele and emptying disturbances.
To highlight the importance of comprehensive preoperative assessment for optimizing surgical outcomes.

Main Methods:

Defecography
Anorectal manometry
Colon transit time studies
Electromyography

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Main Results:

71% of patients with rectocele and emptying disturbances had a concomitant paradoxical sphincter reaction.
13 of these patients also exhibited increased colon transit time.
A significant overlap exists between rectocele, paradoxical sphincter reaction, and delayed colon transit.

Conclusions:

Patients with rectal emptying difficulties and rectocele frequently present with multiple contributing factors, including paradoxical sphincter reactions and altered colon transit.
Thorough preoperative investigations are essential to identify all causes of dysfunction before surgical intervention for rectocele.
Addressing all identified etiological factors preoperatively may improve functional outcomes after rectocele surgery.