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Overt Rectal Prolapse and Fecal Incontinence

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

PURPOSE

Rectal prolapse is frequently associated with fecal incontinence; however, the relationship is questionable. The study was designed to evaluate fecal incontinence in a large consecutive series of patients who suffered from rectal prolapse, focusing on both past history, anal physiology, and imaging.

METHODS

Eighty-eight consecutive patients who suffered from an overt rectal prolapse (72 women, 16 men; mean age, 51.1 ± 19.5 years) as a main symptom were analyzed; 48 patients also experienced fecal incontinence compared with 40 without incontinence. Logistic regression analyses were performed.

RESULTS

The two groups of patients did not differ with respect to parity, weekly stool frequency, main duration of symptoms before referral, occurrence of dyschezia, and digital help to defecate. Patients with prolapse who were older than 45 years (odds ratio (OR), 4.51 (1.49–13.62); P = 0.007) and those with a past history of hemorrhoidectomy (OR, 9.05 (1.68–48.8); P = 0.01) were significantly more incontinent. Incontinent group showed frequent internal anal sphincter defect compared with the continent group (60 vs. 6.2 percent; P = 0.0018).

CONCLUSIONS

In patients with overt rectal prolapse, the occurrence of fecal incontinence needs special consideration for age and previous hemorrhoid surgery as causative factors. Anal weakness and sphincter defects are frequently observed.

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Authors and Affiliations

  1. Gastroenterology Unit, Rennes University Hospital, Rennes, France

    Laurent Siproudhis M.D., Ph.D., Marianne Eléouet M.D., Agathe Rousselle M.D., Mounia El Alaoui M.D. & Jean-François Bretagne M.D.

  2. Physiology Unit, Rennes University Hospital, Rennes, France

    Alain Ropert M.D., Ph.D.

Authors
  1. Laurent Siproudhis M.D., Ph.D.
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  2. Marianne Eléouet M.D.
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  3. Agathe Rousselle M.D.
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  4. Mounia El Alaoui M.D.
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  5. Alain Ropert M.D., Ph.D.
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  6. Jean-François Bretagne M.D.
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Correspondence to Laurent Siproudhis M.D., Ph.D..

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Siproudhis, L., Eléouet, M., Rousselle, A. et al. Overt Rectal Prolapse and Fecal Incontinence. Dis Colon Rectum 51, 1356–1360 (2008). https://doi.org/10.1007/s10350-008-9353-x

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  • DOI: https://doi.org/10.1007/s10350-008-9353-x

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