Anorectal function in patients with complete rectal prolapse. Differences between continent and incontinent...

Area of Science:

• Gastroenterology and Colorectal Surgery
• Pelvic Floor Disorders
• Neurophysiology

Background:

• Rectal prolapse is a condition affecting anorectal function.
• Fecal continence is a critical outcome in rectal prolapse management.
• Understanding the physiological differences between continent and incontinent rectal prolapse patients is crucial for targeted treatment.

Purpose of the Study:

• To investigate anorectal physiological alterations in rectal prolapse patients.
• To compare fecal continence and incontinence groups within rectal prolapse.
• To evaluate differences in neuromuscular function and anal canal pressures.

Main Methods:

• Study included 18 rectal prolapse patients (8 continent, 10 incontinent) and 22 healthy controls.
• Methods included clinical examination, perineal descent measurement, anorectal manometry, and electrophysiology.
• Anorectal sensitivity to electrical stimuli was assessed.

Main Results:

• Both continent and incontinent rectal prolapse groups exhibited a hypotonic anal canal at rest and during voluntary squeeze compared to controls.
• Incontinent patients had significantly lower resting anal canal pressure and longer pudendal motor latency.
• Pudendal neuropathy was more prevalent and severe in incontinent patients.

Conclusions:

• Rectal prolapse is associated with a hypotonic anal canal, irrespective of fecal continence.
• Continent rectal prolapse patients demonstrate less pudendal neuropathy and better voluntary sphincter squeeze function than incontinent patients.