Anal continence after perineal approach versus posterior abdominal rectopexy in complete rectal prolapse

ABSTRACT

Twenty-five cases of complete rectal prolapse [nine males and sixteen females] with a mean age of 49 years were operated upon. In fifteen cases [mean age 37 years], posterior abdominal rectopexy was performed [first group] and in ten cases [mean age 58 years], perineal rectopexy was used [second group]. Clinical evaluation and FMG of anal sphincters were performed in all cases preoperatively and three months postoperatively, competing the results in both groups. In the first group, eleven cases were incontinent to solid and /or liquid feces and four cases were incontinent to flatus before the operation. After the operation, complete prolapse was successfully controlled in thirteen cases and in two cases, there was partial rectal prolapse. It was concluded that both posterior abdominal rectopexy and perineal procedure are effective in controlling the associated anal incontinence with complete rectal prolapse. The perineal approach is less successful but it has an advantage of being safe in elderly high risk patients considered too unfit for transabdominal surgery