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Related Experiment Videos

Incontinence and rectal prolapse: a prospective manometric study.

J G Williams1, W D Wong, L Jensen

  • 1Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis 55455.

Diseases of the Colon and Rectum
|March 1, 1991
PubMed
Summary

Surgery for rectal prolapse can significantly improve fecal incontinence by enhancing sphincter function. Preoperative anal pressures are key indicators of continence outcomes after prolapse repair.

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Rectal prolapse is a condition affecting the pelvic floor.
  • Fecal incontinence is a common comorbidity of rectal prolapse.
  • Surgical correction of rectal prolapse may impact continence.

Purpose of the Study:

  • To investigate the effect of rectal prolapse surgery on fecal incontinence.
  • To evaluate manometric parameters of anal sphincter function before and after surgery.
  • To identify predictors of continence outcomes.

Main Methods:

  • Prospective manometric study of 23 female patients with rectal prolapse.
  • Assessment of internal and external sphincter function.
  • Measurement of resting anal pressure and maximum voluntary contraction pressure.

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  • Evaluation of resting anorectal angle.

    • Main Results:

    • Seven of 14 incontinent patients regained continence post-surgery; two improved.
    • Significant increases in resting anal pressure and maximum voluntary contraction pressure were observed postoperatively.
    • Preoperative resting anal pressure and maximum voluntary contraction pressure were significantly lower in patients with persistent incontinence.
    • Preoperative resting anorectal angle was more acute in continent patients.

    Conclusions:

    • Surgical correction of rectal prolapse improves internal and external sphincter function, leading to better continence.
    • Low preoperative resting anal pressure (<10 mm Hg) and maximum voluntary contraction pressure (<50 mm Hg) predict persistent incontinence after surgery.
    • Manometric parameters are valuable in assessing continence outcomes in rectal prolapse patients.