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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transabdominal posterior rectopexy with resection of the redundant left colon (Frykman-Goldberg operation) was performed on 48 selected patients with complete rectal prolapse. Uterine suspension was also performed on most of the women. The 30-day mortality rate was 2.1%. Prolapse recurred in 4 (9%) of the 45 patients followed up for 1-10 (mean 4.3) years. There were no complications attributable to bowel resection or anastomosis. Adequate data on both preoperative and postoperative anal function and bowel habit were available in 41 cases. All but two of the 32 patients with associated incontinence experienced improved anal control after the operation (9 regained normal continence). Bowel habit improved in 23 patients (56%), especially in those with chronic constipation. No patient reported increased problems of bowel management. The operation does not involve the risks associated with implantation of foreign material and can be especially beneficial for constipated patients with rectal prolapse who are fit for major abdominal surgery.
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PMID:Abdominal rectopexy and sigmoid resection (Frykman-Goldberg operation) for rectal prolapse. 337 79

Over a 2 1/2 year period a prospective study was undertaken to evaluate the occurrence and symptoms of rectal intussusception (internal procidentia). The condition was found in 28 female patients. 17 patients were operated on due to severe obstruction during defaecation, perineal pain, solitary rectal ulcer syndrome, and partial incontinence. The endopelvic findings were similar to those encountered in patients with complete, external rectal prolapse, and the operative procedure was identical (rectal mobilization, elevation, fixation, with rectosigmoid resection in most cases). Results were favorable. Conservative treatment seemed to be adequate in 7 of the 11 remaining patients.
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PMID:[Internal rectal prolapse]. 338 80

Electromyographic studies in young adults with rectal prolapse have shown that there are a group of persons who cannot pull their prolapses in who have got very abnormal electromyograms. If this group are treated with major pelvic floor surgery the electromyogram appears to return to almost normal in two years. There are other young adults with rectal prolapse who can pull the prolapse in by contracting their own pelvic floors whose electromyograms approximate more closely to the normal. This latter group were treated with the insertion of circumanal nylon. It seems possible to differentiate the two groups without using electromyography on the basis of whether or not they can pull in the prolapse by contracting the pelvic floor and therefore the selection between patients for major surgery and minor surgery can be a clinical one. Further it would seem that as an initial operation, even the patients who are in the bad group can be treated by good bowel training and in a lesser operation, that if the bowel is kept in, the electromyograph returns to normal and hopefully in some of the patients major surgery is avoided.
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PMID:Rectal prolapse in young adults. 343 22

A new operation that has been found effective in the treatment of frequently recurring rectal prolapse in children is described. It involves excision of narrow strips of mucosa at three or four quadrants and inserting nonabsorbable sutures in the denuded area to pleat the prolapsed segment. The technique is simple, safe, and effective for both mucosal prolapse and full-thickness rectal prolapse. It is free from major complications. The controversy surrounding the predisposing factor, the nature of the prolapse, and the various suggested treatments are highlighted.
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PMID:Quadrant mucosal stripping and muscle pleating in the management of childhood rectal prolapse. 351 Dec 14

Rectal prolapse and solitary rectal ulcer syndrome are both benign conditions affecting the rectum, mainly in women; prolapse tends to occur late in life, while solitary rectal ulcer syndrome has a predilection for the younger adult. Complete rectal prolapse probably starts as a mid-rectal intussusception, although a combination of this theory and the 'sliding hernia' theory has been proposed by Altemeier et al (1971). The pelvic floor weakness associated with prolapse, which gives rise to incontinence, is most likely due to a traction injury to the pudendal nerve. Anorectal manometry will indicate those incontinent patients likely to benefit from rectopexy. Abnormal descent of the perineum may be found in rectal prolapse and solitary rectal ulcer syndrome as well as descending perineum syndrome per se. The clinical features of these three conditions can overlap. Solitary rectal ulcer syndrome is essentially due to prolapse and traumatization of the rectal mucosa. Inappropriate puborectalis contraction, abnormal perineal descent, and overt rectal prolapse have all been cited as possible mechanisms of development of the condition. Defecography is the radiologic investigation of choice. Electromyography, as in rectal prolapse, may show evidence of pudendal nerve damage although incontinence is rare.
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PMID:The pathogenesis and pathophysiology of rectal prolapse and solitary rectal ulcer syndrome. 353 17

The hypothesis that SRUS and localized CCP are analogous syndromes is supported by the similarities in clinical presentation and biopsy pathology of patients with these conditions. The theory that rectal mucosal prolapse causes SRUS and localized CCP is strengthened by the observation of like pathology in other clinical situations and various animal models in which mucosal prolapse occurs. However, rectal prolapse is not clinically demonstrable in all patients. Therefore, the definitive diagnosis of SRUS and localized CCP must depend upon the recognition of specific histopathologic features in rectal biopsy specimens from ulcer margins or otherwise abnormal mucosa. Conservative medical management is satisfactory for most patients, and surgical intervention should be reserved for highly selected patients.
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PMID:"Solitary" rectal ulcer syndrome. Are "solitary" rectal ulcer syndrome and "localized" colitis cystica profunda analogous syndromes caused by rectal prolapse? 353 53

Twenty-four consecutive patients (mean age: 74 years) with complete rectal prolapse, fifteen of whom were incontinent of solid stool, have been treated by postanal repair and intersphincteric Ivalon sponge rectopexy. There was no operative mortality, or serious morbidity. There was one recurrence of complete prolapse which occurred 14 days after operation. The other 23 patients have been followed for up to 4 years. All patients who were incontinent of solid stool pre-operatively have been rendered continent. This type of operation may be the treatment of choice in the elderly, where an abdominal procedure is considered unwise and in cases of rectal prolapse associated with faecal incontinence.
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PMID:Postanal repair and intersphincteric Ivalon sponge rectopexy for the treatment of rectal prolapse. 359 29

The results of surgical treatment of rectal prolapse in 50 consecutive adult patients were evaluated. The mean age of the patients was 51.8 +/- 15.9 years. 8 of the patients were males. 13 of the patients had recurrent prolapse after operations performed earlier elsewhere. There were 4 types of operations: Delorme's mucosal sleeve resection (n = 21), perineal rectosigmoidectomy (n = 7), low anterior resection (n = 12) and abdominal rectopexy (n = 10). There was no operative mortality. The main postoperative complications were perforation or stricture of the rectum in the Delorme group and ileus and anastomotic complications in the low anterior resection group. The frequency of postoperative complications was clearly highest in the low anterior resection group (67%). Follow-up examination was performed 5.2 +/- 3.9 years postoperatively. The recurrence rate of prolapse was highest after perineal operations. Fecal incontinence was almost always associated with recurrence of prolapse and its incidence increased with reoperation. In conclusion, abdominal rectopexy was superior to other forms of operation in the treatment of rectal prolapse. Successfull correction of rectal prolapse does not necessarily rule out the need for later surgery for faecal incontinence.
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PMID:Treatment of rectal prolapse. A clinical study of 50 consecutive patients. 367 23

The Delorme operation has been used to treat 27 consecutive patients with complete rectal prolapse. The mean age in this group was 74 years and the average length of the prolapse was 12 cms. There was no postoperative mortality or morbidity. The follow-up ranges from 11 months to 64 months (mean 35 months) and so far there have been two recurrences. One of these has been successfully treated by a second Delorme operation. The second patient has declined further surgery. This low recurrence rate combined with the minor nature of the procedure suggests that the Delorme operation should be considered in all patients presenting with complete rectal prolapse.
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PMID:Delorme's operation: the first choice in complete rectal prolapse? 372 63

In infancy there are two types of rectal prolapse. One type is less pronounced and intermittent. This type occurred in 9 out of 17 children referred for rectal prolapse and ceased after a few weeks' conservative treatment. The other type is a more pronounced prolapse occurring at nearly each defecation and lasting several weeks or months. These patients may need an operation, especially when ulceration of the mucosa occurs. In our patients, a Lockhart-Mummery operation was used successfully in all but one patient. No complications were observed. Though less extensive treatment, such as submucosal injection of sclerosing agents, is recommended to be the first method of choice because pathoanatomically the prolapse in infancy is frequently a prolapse of the mucosa, in patients where this therapy does not succeed, a Lockhart-Mummery operation may be an alternative.
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PMID:Rectal prolapse in infancy: conservative versus operative treatment. 378 75


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