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BACKGROUND: The role of internal rectal prolapse in the origin of fecal incontinence remains to be defined. In our institution, laparoscopic ventral rectopexy is offered to patients with high-grade internal prolapse and fecal incontinence. OBJECTIVE: The present study was designed to evaluate the functional outcome after laparoscopic ventral rectopexy in patients with fecal incontinence associated with high-grade internal rectal prolapse. DESIGN: This study was designed as a prospective observational study. SETTINGS: The study took place in a university hospital. PATIENTS: Between 2009 and 2011, 72 patients with fecal incontinence not responding to maximum medical treatment (including biofeedback) were included. All patients had a grade III or grade IV rectal prolapse. INTERVENTION: Laparoscopic ventral rectopexy was performed. MAIN OUTCOME MEASURES: Preoperative endoanal ultrasonography and anorectal manometry were performed. Fecal continence was evaluated by using the Rockwood Fecal Incontinence Severity Index score before and 1 year after surgery. RESULTS: The median fecal incontinence severity index score 1 year after surgery was lower than the median score before surgery (15 versus 31; p < 0.01), representing an improvement in fecal continence. LIMITATIONS: This was a preliminary observational study with no control group, no postoperative proctography, and no postoperative anal physiology. CONCLUSION: Laparoscopic ventral rectopexy can improve symptoms of fecal incontinence in patients with a high-grade internal rectal prolapse. Internal rectal prolapse contributes to the multifactorial origin of fecal incontinence.

Original publication

DOI

10.1097/DCR.0b013e3182a85aa6

Type

Journal article

Journal

Dis Colon Rectum

Publication Date

12/2013

Volume

56

Pages

1409 - 1414

Keywords

Adult, Aged, Aged, 80 and over, Anal Canal, Fecal Incontinence, Female, Humans, Laparoscopy, Male, Manometry, Middle Aged, Prospective Studies, Rectal Prolapse, Rectum, Surveys and Questionnaires, Treatment Outcome