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Updated: Mar 28, 2026
07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
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High-grade internal rectal prolapse: Does it explain so-called "idiopathic" faecal incontinence?
A L A Bloemendaal1, N C Buchs1, S Prapasrivorakul1
1Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, United Kingdom.
International Journal of Surgery (London, England)
|December 25, 2015
Summary
High-grade internal rectal prolapse is common in women with faecal incontinence, especially urge incontinence. Defecation proctography is recommended for diagnosing internal rectal prolapse in these patients.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Faecal incontinence (FI) is a complex condition with various causes.
- The association between internal rectal prolapse (IRP) and FI is debated.
- Recent evidence highlights the significance of high-grade IRP in FI etiology.
Purpose of the Study:
- To investigate the incidence and relevance of IRP in female patients with FI.
- To specifically examine patients without anal sphincter defects.
Main Methods:
- Analysis of prospectively collected data from a pelvic floor database.
- Inclusion criteria: females with moderate to severe pure FI, no obstructed defecation, and no sphincter defects.
- Evaluation of defecation proctography, anorectal physiology, and incontinence scores.
Main Results:
- 174 females met inclusion criteria from 2082 patients.
- High-grade IRP detected in 49% of patients, primarily linked to urge FI.
- Low-grade IRP was associated with passive FI; lower resting pressure in high-grade IRP and older patients.
Conclusions:
- High-grade IRP is prevalent in female FI patients, particularly those with urge FI, even without sphincter lesions.
- Defecation proctography is crucial for the routine evaluation of faecal incontinence.
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