[Intestinal prolapse and/or fecal incontinence: therapy possibilities]

Many patients with rectal prolapse and/or fecal incontinence could be helped if they disclosed the ailment to their physician. Thirteen out of 23 patients underwent transabdominal rectopexy and remained recurrence-free, whereas only one out of 10 anal cerclages brought relief of symptoms. Simultaneous incontinence was also eliminated in most cases by rectopexy. Thirty-one patients with incontinence in the absence of traumatic sphincter lesions or urgency grade 2 were treated either by voluntary training of the pelvic floor muscles in combination with faradic stimulation, or by postanal repair. Fifteen patients regained continence or showed some improvement. Thirteen of the remaining 16 patients were healed or improved after postanal repair. The authors therefore recommend transabdominal rectopexy for rectal prolapse. In cases of simultaneous incontinence the rectopexy should be performed first. If a course of training of the pelvic floor muscles produces no improvement, postanal repair is advisable.