Radiological Changes After Resection Rectopexy in Patients with Rectal Prolapse—Influence on Clinical Symptoms and Quality of Life
Resection rectopexy is performed to correct the anatomic defect associated with rectal prolapse. The aim of the study was to determine whether the change in the radiological prolapse grade has an influence on patients’ symptoms and quality of life.
The study investigated 40 patients who underwent resection rectopexy for rectal prolapse. The following were determined before and after surgery: radiological prolapse grade, anorectal angle and pelvic floor position in defecography, clinical symptoms (Cleveland Clinic Incontinence and Constipation Scores, Kelly-Hohlschneider Score), quality of life.
Defecography revealed postoperative improvement in the prolapse grade and pelvic floor position (p < 0.05). The clinical symptoms and quality of life improved in both, the total population (n = 40) and in patients with improved radiological prolapse grade (n = 30): all clinical scores (p < 0.05), SF-36 (vitality, social role, mental health p < 0.05), and Fecal Incontinence Quality of Life Scale (lifestyle, coping, embarrassment p < 0.05). Patients without improved radiological findings showed no change in their symptoms or quality of life.
Our study demonstrates that the radiological prolapse grade is improved by resection rectopexy. Correction of the anatomic defect was associated with improvement in symptoms and quality of life. Defecography may therefore be useful in the postoperative assessment of persistent symptoms or reduced quality of life.
KeywordsResection rectopexy Rectal prolapse Radiological prolapse grade Quality of life Defecography
- 1.Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society 2005;94(3):207–210.Google Scholar
- 2.Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract 2014;18(5):1059–1069.CrossRefGoogle Scholar
- 5.Cariou de Vergie L, Venara A, Duchalis E, Frampas E, Lehur PA. Internal rectal prolapse: Definition, assessment and management in 2016. J Visc Surg 2016; S1878–7886.Google Scholar
- 6.Tou S, Brown SR, Nelson RL. Surgery for complete (full-thickness) rectal prolapse in adults. The Cochrane database of systematic reviews 2015;11:CD001758.Google Scholar
- 7.Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, Pucciani F, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World journal of gastroenterology: WJG 2012;18(36):4994–5013.CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Bove A, Pucciani F, Bellini M, Battaglia E, Bocchini R, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V, Gambaccini D, Bove V. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World journal of gastroenterology: WJG 2012;18(14):1555–1564.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Willis S, Faridi A, Schelzig S, Hoelzl F, Kasperk R, Rath W, Schumpelick V. Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 2002;387(2):101–107.CrossRefGoogle Scholar
- 17.Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, Wexner SD, Bliss D, Lowry AC. Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Diseases of the colon and rectum 2000;43(1):9–16; discussion 16-17.CrossRefPubMedGoogle Scholar
- 19.Reichert M, Busse A, Hecker A, Askevold I, Kampschulte M, Wüsten O, Krombach GA, Schwandner T, Padberg W. Changes in Dynamic Pelvic Floor Magnet Resonance Imaging and Patient Satisfaction after Resection Rectopexy for Obstructed Defecation Syndrome. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2016;188(1):38–44.PubMedGoogle Scholar
- 20.Makela-Kaikkonen J, Rautio T, Paakko E, Biancari F, Ohtonen P, Makela J. Robot-assisted versus laparoscopic ventral rectopexy for external, internal rectal prolapse and enterocele: a randomised controlled trial. Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland 2016.Google Scholar