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

The present classification of first, second, and third grade hemorrhoids only reflects variation in size of a normal human tissue and does not relate to "hemorrhoidal disease." Cross-sections and coronal sections of the anal canal in 32 fetuses, with ages ranging from 28 to 38 weeks of development, were studied and the following fundamental facts were found: in the lumen of the anal canals of fetuses, there are prominences of mucosa formed by conjunctive and muscular tissue, arterial and venous vessels and glands, arranged without following any particular pattern, which resemble similar formations found in the adult that protrude equally in the inside of the canal, known as hemorrhoids. The muscular tissue, smooth or striated, is grouped in bundles, and bunches of collagen fibers of homogeneous, nonfragmented, and regular aspect are found between them. Blood vessels have an ample lumen with a defined structure of collagen tissue as well as muscular tissue in its walls. Prominences of mucosa are connected to the remainder of the intestinal wall by defined conjunctive thick, nonfragmented fibers, that permit firm adherence. In healthy adults, the findings were similar but there was an evident degenerative process in the collagen fibers. In 100 surgical specimens of hemorrhoidectomies, the histologic investigation demonstrated a severe inflammatory reaction that especially affected the blood vessel wall and conjunctive tissue, which probably produced an ischemic lesion of the mucosa that could condition the onset of a vascular thrombosis, allowing displacement of the mucosa and its protrusion through the anus. The files of 815 patients suffering from hemorrhoidal disease were also studied. The main physical findings were bleeding, thrombosis of the internal hemorrhoidal plexus, prolapse of the anal cushions, or a combination of these. The authors propose to classify hemorrhoidal disease as bleeding, prolapsing, thrombotic, and mixed hemorrhoidal disease, aiming toward a rational treatment.
Dis Colon Rectum 1988 Jun
PMID:Histoclinical basis for a new classification of hemorrhoidal disease. 337 71

To investigate the physiology of improvement in continence following the Ripstein operation for procidentia, preoperative and postoperative anorectal manometry was performed on 11 patients. The mean maximum anal resting pressure increased from 39 to 55 mm Hg (P = 0.01). This probably reflects improved function of the internal anal sphincter, which might contribute to better continence by increasing the closing capacity of the anal canal.
Dis Colon Rectum 1986 Aug
PMID:Increased anal resting pressure following the Ripstein operation. A contribution to continence? 373 62

Over 15 years 108 patients with either rectal prolapse or internal rectal procidentia were treated by the Ripstein operation. Postoperative evaluation was possible in 97 patients (mean observation time, 6.9 years). The mortality rate was 2.8 percent, and surgical complications occurred in an additional 3.7 percent. The recurrence rate was 4.1 percent. Preoperative and postoperative functional analysis was possible in 92 patients. The proportion of continent patients increased from 33 percent preoperatively to 72 percent postoperatively. Defecation difficulties increased from 27 percent to 43 percent following surgery, and were a major cause of dissatisfaction.
Dis Colon Rectum 1986 Dec
PMID:Results of the Ripstein operation in the treatment of rectal prolapse and internal rectal procidentia. 379 66

Although the colonofiberscope has undergone various modifications and improvements, the insertion principle remains unchanged; that is, pushing and rotation and the elasticity of the scope itself are inevitable. It often is difficult to maintain proper balance among these dynamic factors; imbalance prevents deep insertion. Over-elongation of the scope leads to insertion failure, particularly if there are adhesions of the sigmoid colon, overextension of the colon, or transverse colon ptosis. Our "leading cord" method is an excellent aid to colonofiberscopy. It can be inserted from the clamp hole of a conventional fiberscope and hardened to straighten the scope, thereby permitting deep insertion. With this technique the region from the rectum to the descending colon, as well as a ptosed transverse colon, can be straightened. Our clinical experience indicates that the rate of successful insertions in colonofiberscopy will be increased considerably with this complementary device.
Dis Colon Rectum 1986 Dec
PMID:The leading cord method of colonofiberscopy. 379 72

Twenty-one patients were reviewed five to 12 years after silicone rubber perianal suture for rectal prolapse. Sixteen patients (76 percent) were continent with control of prolapse and two patients (9 percent) suffered only from occasional prolapse or incontinence. Rebanding for silicone cutout or fracture was required in four patients and a second rebanding operation was needed in two. Silicone rubber perianal suture for rectal prolapse stands the test of time and might be recommended for more widespread use in younger patients.
Dis Colon Rectum 1987 Feb
PMID:Late results of silicone rubber perianal suture for rectal prolapse. 380 26

Colorectal surgeons are frequently faced with rectocele patients who have distressing bowel difficulty and anorectal complaints. In 1977, a new technique of transrectal repair of rectocele operating through a standard Fansler operating speculum was developed. The principle of the repair is based on the technique of Sullivan, as described elsewhere. The main difference is in dealing with the mucosal prolapse. A total of 355 cases of transrectal repair of rectocele was compiled for study covering a period from 1977 to 1982. Ninety-eight percent of patients have improved. Only 2 percent reported no improvement after surgery. There was a 5.6 percent overall infection rate. With refinement of the technique, no infection has been observed in the last 96 cases of the series.
Dis Colon Rectum 1985 Jun
PMID:Transrectal repair of rectocele: an extended armamentarium of colorectal surgeons. A report of 355 cases. 389 Dec 60

A technique for constructing a permanent transverse loop colostomy that permits distal decompression without risk of distal limb prolapse is described.
Dis Colon Rectum 1986 Jan
PMID:A modification of the transverse loop colostomy. 394 Aug 10

The solitary rectal ulcer and colitis cystica profunda are different manifestations of the solitary rectal ulcer syndrome. The cause of solitary rectal ulcer syndrome remains unknown. Since defecation disorders are common among patients with solitary rectal ulcer syndrome, defecography is indicated. Defecography was performed on 19 patients with solitary rectal ulcer syndrome. In five patients, the spastic pelvic floor syndrome had occurred. Twelve patients had internal intussusception of the rectum, and one patient had an anterior rectal wall prolapse. In one patient, no abnormalities could be detected. These abnormalities led to severe straining, which can damage the anterior rectal wall. Findings strongly support the hypothesis that solitary rectal ulcers are traumatic lesions caused by straining. Defecography is a suitable procedure for detecting the causative disorder of defecation and for selecting patients for treatment.
Dis Colon Rectum 1986 Feb
PMID:Diagnosis of functional disorders of defecation causing the solitary rectal ulcer syndrome. 394 22

This is a retrospective study evaluating 179 patients with complete rectal prolapse operated on at the University of Minnesota affiliated hospitals from 1953 to 1983 with no mortality. One hundred and two of 138 patients who underwent abdominal proctopexy and sigmoid resection were followed from six months to 30 years with a recurrence rate of 1.9 percent. Twenty-two of the 33 patients who underwent perineal rectosigmoidectomy were followed from six months to three years with no recurrence. Nine patients who underwent abdominal proctopexy and subtotal colectomy because of colonic inertia associated with procidentia were followed from one to six years with no recurrence. Patient interviews revealed that 72 to 80 percent considered their results as excellent or good. Incontinence or persistent constipation caused the remaining patients to consider their results fair or poor, despite anatomic correction of the prolapse. Abdominal proctopexy and sigmoid resection was more likely to result in improvement of continence than was perineal rectosigmoidectomy.
Dis Colon Rectum 1985 Feb
PMID:The management of procidentia. 30 years' experience. 397 14

The results of abdominal mobilization of the rectum and repair of the pelvic floor behind the anorectal junction are reported in 23 patients with rectal prolapse, being accompanied by some form of anal incontinence in 12. Within 20 months, on the average, three patients had recurrent prolapse. Two thirds of the patients with incontinence for solid and/or fluid feces were cured for prolapse as well as incontinence. Seven became constipated, while 14 were fully satisfied. Seven of eight patients with a highly reduced tone of the external sphincter before surgery had a marked improvement after surgery. The results do not differ greatly from those after the suspension operation or repair of the pelvic floor in front of the rectum, despite being more physiologic, but suggest that simultaneous suspension and abdominal repair of the pelvic floor may avoid the need for a secondary postanal repair from below in patients with persistent incontinence after suspension surgery. A controlled, randomized trial is advocated.
Dis Colon Rectum 1985 Aug
PMID:Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation. 401 21


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