Rectal prolapse.
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ABSTRACT:
SUBMITTER: Goldstein SD
PROVIDER: S-EPMC3140332 | biostudies-other | 2011 Mar
REPOSITORIES: biostudies-other
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Project description:OBJECTIVES:Pelvic organ prolapse (POP) POP is defined as the protrusion of pelvic organs from the vaginal canal. POP often coexists with internal rectal prolapse or external rectal prolapse (ERP). A series of patients with coexisting POP and ERP who underwent laparoscopic ventral rectopexy (LVR) combined with laparoscopic sacrocolpopexy (LSC) are reported here. METHODS:Seven patients underwent LVR and LSC together. Fecal incontinence was assessed by the Fecal Incontinence Severity Index (FISI), constipation was assessed by the Constipation Scoring System (CSS), and urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Anatomical disorders were assessed by Pelvic Organ Prolapse Quantification (POP-Q) and defecography. RESULTS:The patients' median age was 81 (60-88) years. The median operative time was 380 (282-430) minutes. The median postoperative hospital stay was 3 (1-5) days. There were no postoperative complications. The FISI, CSS, POP-Q, and defecography findings improved postoperatively; however, the ICIQ-SF deteriorated in 2 of 5 patients. CONCLUSIONS:LVR combined with LSC for coexisting POP and ERP is feasible.
| S-EPMC6768687 | biostudies-literature
Project description:Complete prolapse of rectum (procedentia) is said to occur when the full circumference of the rectal wall is everted through the anus. Numerous techniques have been developed in order to treat procedentia, an uncommon pathology that is managed occasionally by the general surgeon. A simple, safe and effective procedure is recommended for surgeons who treat procedentia recti once in a while. We describe a simple rectopexy procedure which has been used effectively in 38 patients in the last 10 years. In this prospective study we evaluated the results which are comparable to other standard operative techniques in terms of morbidity, anatomic correction and bowel function. This technique is based on sound scientific principles in the aetiopathogenesis of rectal prolapse. This procedure obliterates the abnormally deep cul de sac of rectovesical pouch and supports the anterior rectal wall by suturing it to the bladder base to prevent initiation of sliding herniation of anterior rectal wall, which causes procedentia recti. Posterior dissection fibrosis fixes the posterior rectal wall to the sacrum after healing and restores the normal posterior curve of rectal canal and corrects the pathogenic straightening of rectum which promotes prolapse. Minimal mobilization of rectum is done and lateral ligaments are not dissected hence all attendant complications e.g. impotence, urinary incontinence, constipation etc are avoided. Simplicity, effectiveness, safety and non requirement of prosthetic material makes it an ideal operation suitable for a general surgeon working in the periphery.
| S-EPMC5531899 | biostudies-other
Project description:Background:rectal prolapse can cause bleeding and fecal incontinence that affects the life quality of patients. The treatment of external rectal prolapse is surgical. There are many procedures (abdominal or perineal) that can be used depending on the severity of the condition and patient tolerability for operation. In this study, a simple safe procedure is used for the treatment of the rectal prolapse in old, fragile and comorbid patients who cannot withstand the major surgeries and the risk of long-duration anesthesia. Methods:from December 2016 to July 2019, 36 elderly comorbid patients with rectal prolapse were involved in this study which is performed in the GIT surgery unit of Zagazig University Hospital. A modified linear stapler resection technique is used for the rectal prolapse. Postoperative follow up was done for one year to evaluate the functional outcome, operative time, hospital stay duration and complications. Result:this study was conducted on 36 patients; The median age was 75 years (range 48-95). The postoperative complication rate was 11.1%. The median operative time was 25 min and 4 days for the hospital stay. Fecal incontinence improved in more than 90% of patients and constipation disappeared in 66% of total constipating patients. Conclusion:The modified perineal linear stapler resection for external rectal prolapse is a good, easy, rapid treatment for elderly comorbid patients with good functional outcomes.
| S-EPMC7167506 | biostudies-literature
Project description:Background:Rectal prolapse (RP) is an uncommon perineal disease. It is defined as a complete protrusion or intussusception of the rectum through the anus. Strangulation of the RP is rare. This complication presents requires an emergent surgery. This case presentation aims to report the therapeutic management and results of this condition. Observation:A 29-year-old men, who consulted for a sudden, painful, irreducible rectal prolapse. At the anus, there was an irreducible, edematous, without signs of ischemia or necrosis rectal prolapse measuring 25*10 cm wide. The laboratory data showed a high white blood cell count and elevated C-reactive protein. After a failure of external manual reduction under general anesthesia, the patient underwent emergent surgery. The procedure consisted of a rectosigmoidectomy with coloanal anastomosis using a perineal approach according to the Altemeier technique associated to a diverting ileostomy. The postoperative follow-up was uneventful. The patient was discharged at post-operative day five. Conclusion:Strangulated RP is a rare complication. Altemeier procedure remains the intervention of choice in this situation.
| S-EPMC7235615 | biostudies-literature
Project description:An enterocele is a pelvic hernia formed from the separation of endopelvic fascia, associated with the posterior or anterior vaginal fornix, and most commonly located in the posterior superior vaginal segment. Rectal prolapse is a debilitating condition in which the mucosa of the rectum protrudes circumferentially from the anus. Surgical repair is the recommended treatment for rectal prolapse, and though there are many different surgical options, there is no consensus on which approach is best. We present a case of anterior rectal prolapse due to enterocele which was treated by correction of enterocele with a vaginal approach and propose some clinical features and diagnostic techniques that may distinguish this entity from traditional rectal prolapse.
| S-EPMC6961605 | biostudies-literature
Project description:Tuberculosis of the colon commonly involves the ascending,transverse, or sigmoid colon while rectal involvement in tuberculosis is uncommon and poorly characterized. We report a six-year-old male from Nepal who presented with abdominal pain and difficulty passing stool for two years. On per rectal examination, palpation revealed a circumferential rectal mass. On further evaluation, CT scan showed mural thickening and luminal narrowing in the ano-rectum. Colonoscopy with biopsy showed caseating granuloma and positive acid fast bacilli culture consistent with tuberculosis. After starting anti-tubercular therapy, the patient's abdominal pain resolved and the patient was able to pass stool normally within two weeks. Colonoscopy three months after starting treatment showed complete resolution of the mass. Gastrointestinal tuberculosis should be considered in cases of children from endemic areas who present with a rectal mass.
| S-EPMC6287574 | biostudies-literature
Project description:INTRODUCTION:Incarceration and necrosis of rectal prolapse is rare but when it occurs it requires urgent management. Perineal rectosigmoidectomy (Altemeier's procedure) may be a reasonable approach for the treatment of this condition. In some cases, a diverting stoma may be necessary. METHODS:We report two cases of incarcerated massive rectal prolapse, one of which also manifested tissue necrosis, that were successfully treated with perineal rectosigmoidectomy. In one case a diverting colostomy was required. Both patients recovered uneventfully. RESULTS:A literature review was performed to determine the optimal management of incarcerated and necrotic rectal prolapse, and to determine the indication for fecal diversion. CONCLUSION:Perineal rectosigmoidectomy (Altemeier's procedure) can be utilized in emergency circumstances and, in our experience, the procedure was both safe and effective. The need for fecal diversion depends on the condition of the patient and the experience and judgement of the surgeon.
| S-EPMC6170932 | biostudies-literature
Project description:Several different procedures have been described for surgical treatment of rectal prolapse and consensus on the optimal approach has not been reached. The Swedish Rectal Prolapse Trial was performed with the aim to compare the outcomes after the most common surgical approaches to rectal prolapse. A multicentre randomized trial was conducted from 2000 to 2009. Patients were randomized between a perineal or an abdominal approach for correction of rectal prolapse (randomization A) if eligible for any procedures. Patients considered unsuitable for random allocation were only included in randomizations B or C. Patients in randomization B (perineal group) were randomized to Delorme's or Altemeier's procedures and those in randomization C (abdominal group) to suture rectopexy or resection rectopexy. Primary outcomes were bowel function and quality of life, measured using Wexner incontinence score and RAND-36, and secondary outcomes were complications and recurrence at 3 years. During the study period, 134 patients were randomized: 18 in randomization A group, 80 in randomization B group and 54 in randomization C group; of these, 122 patients underwent surgery. Mean follow-up was 2.6 years. Improvements in Wexner and RAND-36 scores were seen but with no significant difference between the groups. Health change scores were significantly improved from baseline up to 1 year after surgery (P < 0.001). At 3 years, recurrence rates were two of seven patients for abdominal versus five of eight patients for perineal approach (P = 0.315), 18 of 31 patients (58 per cent) for Delorme's versus 15 of 30 patients (50 per cent) for Altemeier's (P = 0.611) and four of 19 patients (21 per cent) for suture rectopexy versus two of 21 patients (10 per cent) for resection rectopexy (P = 0.398). There were no significant differences regarding postoperative complications. For all procedures, significant improvements from baseline in health change scores were noted after surgery. Recurrence rates were higher than previously reported. Registration number: NCT04893642 (http://www.clinicaltrials.gov).
| S-EPMC8769527 | biostudies-literature
Project description:BackgroundThe most common causes of outlet obstructive constipation (OOC) are rectocele and internal rectal prolapse. The surgical methods for OOC are diverse and difficult, and the postoperative complications and recurrence rate are high, which results in both physical and mental pain in patients. With the continuous deepening of the surgeon's concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC, the treatment concepts and surgical methods are continuously improved.AimTo determine the efficacy of the TST36 stapler in the treatment of rectocele combined with internal rectal prolapse.MethodsFrom January 2017 to July 2019, 49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria were selected for treatment using the TST36 stapler.ResultsForty-five patients were cured, 4 patients improved, and the cure rate was 92%. The postoperative obstructed defecation syndrome score, the defecation frequency score, time/straining intensity, and sensation of incomplete evacuation were significantly decreased compared with these parameters before treatment, and the differences were statistically significant (P < 0.05). The postoperative anal canal resting pressure and maximum squeeze pressure in patients decreased compared with before treatment, and the differences were statistically significant (P < 0.05). The initial and maximum defecation thresholds after surgery were significantly lower than those before treatment, and the differences were statistically significant (P < 0.05). The postoperative ratings of rectocele, resting phase, and defecation phase in these patients were significantly decreased compared with those before treatment, and the differences were statistically significant (P < 0.05).ConclusionThe TST36 stapler is safe and effective in treating rectocele combined with internal rectal prolapse and is worth promoting in clinical work.
| S-EPMC8167842 | biostudies-literature
Project description:This case highlights the rare diagnosis of Ogilvie's syndrome after minor surgery in a private hospital where facilities and expertise are generally sparse. It shows the importance of knowledge of the subject, proper assessment, accurate diagnosis, and early input from seniors is crucial to prevent ischemia and perforation of colon that carries high mortality.
| S-EPMC4736515 | biostudies-other