[Rehn-Delorme operation in pelvic floor insufficiency]

Rehn-Delorme's procedure was introduced as one of a couple of methods to remove rectal prolapse with insufficiency of the pelvic floor. Rehn-Delorme's procedure wasn't well accepted until the last twenty years, when some authors reported good results with low recurrence rate of the prolapse, especially for old people with high risk or otherwise unfit for abdominal surgical procedures. On the German Clinic for Diagnostic during the years 1991-1994 in a therapeutical concept of the conjoint problems "chronic constipation--rectal prolapse-faecal incontinence" 205 patients, aged 20 to 86 years, were operated on with that procedure. In a retrospective study, evaluating 78 patients who underwent only that operation, we studied the change of faecal incontinence after removing the outlet obstructing mucosal prolapse. The mortality was zero, the total complication-rate was 15.1%, bleeding (2.9%), suture line disruption (7.3%), abscesses (1.5%) and stenosis (1%) acceptable. The Kirwan continence-score increased significantly. Three cases with normal continence before operation get worse because of removing the obstructing mucosal wall.