Clinical and Physiologic Characteristics of Rectal Prolapse in Males
Journal of the Korean Society of Coloproctology
;
: 223-230, 2000.
Article
in Korean
| WPRIM
| ID: wpr-146038
ABSTRACT
This study compares the sexual differences among rectal prolapse patients regarding the clinical and the physiologic characteristics with emphasis on males. METHODS:
The clinical data, functional status and operative records of 43 patients, who had completed both clinical and functional evaluations were collected in a prospective database and were analyzed according to sex. The functional status of the patients was evaluated by Wexner's constipation score (0~30), Wexner's incontinence score (0~20), anorectal manometry, and pudendal nerve terminal motor latency (PNTML).RESULTS:
The incidences of rectal prolapse in males (n=22) and in females (n=21) were similar. The age of onset for males was lower (mean standard deviation, 19.6 19.59 (50% in childhood) vs 52.0 20.75 years; p=0.001) and the duration of symptoms was longer (31.5+/-19.87 vs 12.5+/-14.31 years; p<0.001). Surgery in males was most commonly performed during the sexually active years (51.2+/-16.34 vs 64.5+/-13.19; p=0.006). The incidence of mucosal prolapse in males was higher (10/22 vs 4/17; p=0.065). The incidences and the severities of defecation difficulty in males and females were similar (n=12, mean Wexner score=8.4 vs n=12, mean Wexner score=9.9; p=NS) but, the incidences and the severities of fecal incontinence were lower in males (n=4, mean Wexner score=4.3 vs n=17, mean Wexner score= 14.2; p<0.001). The maximum resting pressure was higher in males (39.2+/-21.46 vs 26.3+/-19.98 mmHg; p=0.049), and the maximum squeezing pressure was better preserved (131.2+/-62.63 vs 67.5+/-37.99 mmHg; p<0.001). No significant difference existed in the PNTML. Female patients underwent abdominal resection rectopexy (n=6), perineal rectosigmoidectomy with lavatoroplasty (n=11), and Delorme's procedure (n=4), but all male patients preferred the perineal approach (rectosigmoidectomy with lavatoroplasty (n=8), Delorme's procedure (n=14)) for fear of sexual dysfunction after the abdominal approach.CONCLUSIONS:
These findings suggest that the mechanism for developing rectal prolapse in male and female may be different and that surgical treatment should be tailored to the patient.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prolapse
/
Incidence
/
Prospective Studies
/
Rectal Prolapse
/
Age of Onset
/
Constipation
/
Defecation
/
Fecal Incontinence
/
Pudendal Nerve
/
Manometry
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
Korean
Journal:
Journal of the Korean Society of Coloproctology
Year:
2000
Type:
Article
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