[Total rectal prolapse in adults: report of 26 cases in the Ivory Coast]

Several studies are still in progress to improve the results of rectopexy for treatment of full thickness rectal prolapse in adults. The purpose of this study was to evaluate etiologic factors of full thickness rectal prolapse in Ivory Coast and to describe results in 26 patients treated surgically in Africa over a period of 10 years. There were 23 men with ages ranging from 30 to 45 years and 3 women with ages ranging from 45 to 50 years. All three women were multiparous. Related factors in the men were chronic constipation in 69.2%, diarrhea in 11.5%, and dysuria in 7.7%. Fifteen patients (59.7%) presented anal incontinence prior to surgery. Rectoscopy was performed in 23 cases and findings were always normal. Barium enema x-rays were performed in 3 cases and demonstrated dolicho-colon. The Orr-Loygue rectopexy procedure was performed in 23 patients and direct rectopexy in 3 patients. No operative deaths occurred and no recurrences have been observed with a follow-up of 24 months. Constipation developed following surgery in two patients and persisted in all patients who presented this symptom prior to surgery. Progressive improvement was observed in all fifteen patients with preoperative anal incontinence. Based on these results, our current management strategy includes determination of colonic transit time to select indications for direct rectopexy with sigmoidectomy.