Abstract
Twenty-seven patients with rectal prolapse and faecal incontinence were treated by abdominal rectopexy. They were studied clinically and by anal manometry both pre- and postoperatively. Postoperatively eleven patients gained full continence, eight had incontinence for flatus, six were incontinent for liquid stools and only two had daily soiling — none was totally incontinent. Those patients who gained continence had significantly higher maximal basal pressure (MBP) (p<0.05) postoperatively as compared to those who remained incontinent. There was an inverse correlation between MBP and grade of postoperative incontinence (p<0.02). The postoperative increase of MBP correlated (p<0.05) with improving incontinence score. Such changes did not occur with the maximal voluntary contraction pressure (MVCP). Our results suggest that functional recovery of the internal anal sphincter is better in postoperatively continent patients.
Résumé
27 malades avec un prolapsus rectal et une incontinence fécale ont été traités par rectopexie abdominale. Ils ont été étudiés cliniquement et par manométrie anale avant et après l'opération. Après intervention 11 patients avaient une continence entièrement normale, 8 avaient une incontinence pour les gaz et 6 étaient incontinents pour les matières liquides mais 2 seulement avaient des suintements. Aucun n'était totalement incontinent. Les patients qui recouvraient une continence avaient une pression maximale de base (pMB) significativement plus haute après l'opération (p<0.05) comparés à ceux qui restaient incontinents. Il y avait une corrélation inverse entre PMB et le degré d'incontinence post-opératoire (p<0.02). L'augmentation post-opératoire de PMB était corrélée (p<0.05) avec le score d'amélioration de l'incontinence. De telles modifications ne sont pas observées avec la pression de contraction volontaire maximale. Le résultat suggère que l'amélioration fonctionnelle du sphincter interne est meilleure après intervention chez les patients continents.
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Hiltunen, K.M., Matikainen, M. Improvement of continence after abdominal rectopexy for rectal prolapse. Int J Colorect Dis 7, 8–10 (1992). https://doi.org/10.1007/BF01647652
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DOI: https://doi.org/10.1007/BF01647652