FUNCTIONAL RESULTS AFTER TREATMENT OF RECTAL PROLAPSE WITH RECTOPEXY AND SIGMOID RESECTION

Constipation and incontinence are frequent complications of rectal pro lapse. Surgery should not only aim to correct prolapse but also improv e bowel and sphincter function. From 1986-1998 42 patients with procid entia were treated by rectopexy and sigmoid resection. The mean age wa s 61.1 years. Thirty-nine patients were available for follow-up examin ation. Mean follow-up was 54 months. Functional data were collected pr ospectively before the operation and at follow-up and included clinica l parameters, a constipation score, an incontinence score, anal manome try [mean resting pressure (MRP), mean maximum pressure (MMP)], procto graphy [anorectal angle (ARA)] and colonic transit studies [mean trans it time (MTT), rectosigmoid transit time (RSTT)]. The postoperative co mplication rate was 7.1% (n = 3), mortality was 0%. No recurrence was seen. Constipation complaints improved from 33.6% to 25.6% (p < 0.001) and incontinence from 66.6% to 23.1% (p < 0.001). MRP increased from 36.5 mmHg to 46.0 mmHg and MMP from 90.5 mmHg to 103.0 mmHg (p < 0.001 ). ARA changed from 102 to 98 degrees (p < 0.001) and correlated with sphincter tone and continence. MTF decreased from 47.8 to 38.5 hours, segmental transit (RSTT) from 21.1 to 12.7 hours (p < 0.001). Our resu lts indicate that rectopexy with sigmoid resection is a safe and effec tive procedure for rectal prolapse and improves functional disorders o f bowel and sphincter.