Improvement of continence after abdominal rectopexy for rectal prolapse

Twenty-seven patients with rectal prolapse and faecal incontinence were treated by abdominal rectopexy. They were studied clinically and by anal manometry both pre- and postoperatively. Postoperatively eleven patients gained full continence, eight had incontinence for flatus, six were incontinent for liquid stools and only two had daily soiling--none was totally incontinent. Those patients who gained continence had significantly higher maximal basal pressure (MBP) (p less than 0.05) postoperatively as compared to those who remained incontinent. There was an inverse correlation between MBP and grade of postoperative incontinence (p less than 0.02). The postoperative increase of MBP correlated (p less than 0.05) with improving incontinence score. Such changes did not occur with the maximal voluntary contraction pressure (MVCP). Our results suggest that functional recovery of the internal anal sphincter is better in postoperatively continent patients.