Anorectal Physiology in the Rectal Prolapse Patient.
- Author:
Kyung Soo SON
;
Jae Sik JOO
;
Steven D WEXNER
- Publication Type:Original Article
- Keywords:
Rectal prolapse;
Fecal incontinence;
Perineal descent;
Anorectal physiology;
Constipation;
Anorectal manometry;
Defecography
- MeSH:
Anal Canal;
Colorectal Surgery;
Compliance;
Constipation;
Defecography;
Electromyography;
Fecal Incontinence;
Female;
Florida;
Humans;
Male;
Manometry;
Physiology*;
Pudendal Nerve;
Rectal Prolapse*;
Reflex
- From:Journal of the Korean Society of Coloproctology
1998;14(3):467-476
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of our study was to evaluate the physiological spectrum of anorectal dysfunction among patients with full thickness circunferential rectal prolapse. MATERIAL AND METHODS: Between January 1988 and March 1995, 88 patients who visited department colorectal surgery, Cleveland Clinic Florida with rectal prolapse were studied. There were 8 males and 80 females, with a mean age 69 (range 28~101) years. Patients underwent a detailed history and the following anorectal physiology tests were performed: anal canal manometry, pudendal nerve terminal motor latency (PNTML) assessment, anal electromyography and cinedefecography.4 standard continence scoring system, based on the frequency and type of incontinence (0=full continence, 20=complete incontinence) was used. Patients with rectal prolapse (n=88) were divided into two subgroups: Group I=continent patients (n=33) and Group II= incontinent patients (n=55). RESULTS: There were statistically significant differences between each group when comparing mean resting pressures, anal pressures, anal canal length, rectal compliance, rectoanal inhibitory reflex, increased fiber density, the occurrence of premature evacuation (p<0.001), and rectal capacity (p<0.05). However, dynamic changes of anorectal angle, resting anorectal angle, puborectalis length, and rectal sensitivity were not significantly different (p>0.05) between groups. CONCLUSION: Continence may be disturbed in patients with rectal prolapse; knowledge of impairment in continence may assist in surgical management.
