Study of postoperative anal continence after posterior abdominal rectopexy

ABSTRACT

Posterior abdominal rectopexy was performed in 15 patients [6 males and 9 females] with a mean age of 43 years [19 - 67 years], having a full-thickness rectal prolapse. 11 cases were incontinent to solid and/or liquid feces and 4 cases were incontinent to flatus. Clinical evaluation and EMG of anal sphincter were performed for all cases preoperatively and 3 months postoperatively. Posterior abdominal rectopexy was performed using a "proline mesh" for all the patients. Complete prolapse was successfully controlled in 13 cases, and 2 cases showed partial rectal prolapse which was corrected by Goodsall's stitch. Continence was improved significantly after the operation in 10 cases [66.7%] both by clinical evaluation and in EMG. 60% of patients became very satisfied after the operation. However, EMG results were still inferior relative to the normal curve for age and sex. From this study, it was suggested that abdominal repair of the prolapse allows recovery of the internal anal sphincter by removing the cause of persistent rectoanal inhibition