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Postanal repair for faecal incontinence persisting after rectopexy
P Setti Carraro1, R J Nicholls
1St Mark's Hospital, London, UK.
The British Journal of Surgery
|February 1, 1994
Summary
Postanal repair significantly improved fecal incontinence in patients with rectal prolapse after rectopexy. Long-term follow-up showed enhanced continence and anorectal function in most patients.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Persistent fecal incontinence is a challenging complication following rectopexy for rectal prolapse.
- Anorectal physiological deficits often contribute to post-surgical incontinence.
Purpose of the Study:
- To evaluate the long-term efficacy of postanal repair in patients with persistent fecal incontinence after rectopexy.
- To assess changes in anorectal physiology following postanal repair.
Main Methods:
- A cohort of eleven patients with post-rectopexy fecal incontinence underwent postanal repair.
- Clinical outcomes and anorectal physiological parameters were assessed at long-term follow-up (median 76 months).
- Physiological assessments included anal canal length, resting anal pressure, perineal descent, and pudendal nerve terminal motor latency.
Main Results:
- Seven of nine patients demonstrated improved fecal continence at long-term follow-up.
- Significant improvements were observed in anal canal length (2.3 vs 3.5 cm) and resting anal pressure (20 vs 35 cmH2O).
- Postanal repair also led to reduced perineal descent and improved pudendal nerve terminal motor latency.
Conclusions:
- Postanal repair offers a viable and effective long-term solution for fecal incontinence after rectopexy for rectal prolapse.
- The procedure not only improves clinical continence but also normalizes key anorectal physiological parameters.