Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RECTAL PROLAPSE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMedDate not supplied

[Role of radiologic diagnosis in rectal mucosal prolapse].

Defecography (DG) is a useful method to detect many morpho-functional deformities of anus and rectum and pelvic floor. We report on a clinical and radiologic study of 165 patients (36 men and 129 women) suffering from defecation disorders and rectal muscosal prolapse (RMP). All the patients had been submitted to clinical examination, endoscopy and double contrast enema to rule out organic colorectal conditions. DG was performed with a dedicated conmode and high-density barium and videorecorded on VHS cassettes to assess the dynamics of evacuation phases and to reduce exposure doses. DG showed single RMP in 28% of cases and multiple RMP in 72% of cases; the condition was isolated in 22% of cases, while in 88% of cases it was associated with other anorectal dysfunctions, such as rectocele (65%), perineal descent syndrome (PDS) (15%), puborectal muscle syndrome (14%) and intussusception (8%). RMP appeared at DG as a wall defect bulging into rectal lumen, which was more evident under straining and during barium evacuation. In 12 patients with multiple RMP, dynamic CT of the pelvis was carried out to study the whole pelvic floor and in 5 cases it showed levator ani diastasis. Fifty-eight patients were submitted to surgery by elastic binding of RMP; DG follow-up showed RMP remission in 47 patients, single RMP relapse in 3 patients and multiple RMP relapse in 3 patients. One patient with PDS and intussusception was submitted to rectopexy and mucosectom.

Adult↗
PubMed1989

Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients.

Rubber band ligation was used in 160 patients with internal hemorrhoids; 43 of them also had rectal anterior mucosal prolapse; 13 had prolapse alone. Two thirds of the patients underwent a single rubber band ligation and one third a double rubber band ligation in one session without anesthesia. Ninety-four required repeated ligations. A follow-up of 25 +/- 16 months (mean +/- SD) was carried out in 153 of them. Rubber band ligation was followed by prolonged bleeding in six patients and severe pain requiring removal of the rubber band in 12 patients. The complication rate decreased significantly (P less than .05) in the last 80 patients. Compared with multiple ligation, single rubber band ligation in one sitting was followed by a lower complication rate (P less than .01). Long-term results were good in 71 percent of the patients. (A formal hemorrhoidectomy was needed within two years in 6 percent.) A significantly lower recurrence rate of 9 percent was noted in those with normal bowel habits, when compared with constipated subjects whose symptoms recurred in 85 percent (P less than .001). Constipation seems to be a predictable factor in worsening the outcome of rubber band ligation. Rubber band ligation is followed by a lower complication rate when performed in a single ligation.

Constipation↗
PubMed2004

A technique to demonstrate external haemorrhoids.

Although uncommon in children, haemorrhoids are one of the causes of a protruding anal lesion and may be confused with rectal prolapse or prolapse of a rectal polyp. The lesions may not be obvious when the child is anaesthetised because of lack of straining. This may prevent accurate diagnosis and impede identification of the lesion if surgery is being attempted. The authors report 3 cases where a 20 F Foley catheter with 30 ml balloon was inserted rectally and gentle traction applied to reproduce the raised venous pressure generated during straining. On each occasion external haemorrhoids could be demonstrated as the underlying pathology.

Catheterization↗
PubMedDate not supplied

[Laparoscopic +proctopexy].

BACKGROUND: Although not common, rectal prolapse in adults can often be a debilitating conditions. Its only effective treatment is surgical. Among the many procedures described for the treatment of rectal prolapse, abdominal rectopexy is one of the preferred. It consists of fixation of the rectum to the sacrum and does not require any intestinal resection or anastomosis. However, like all open abdominal surgery associated with a large incision this operation may result in significant morbidity which is exacerbated by the advanced age of the patient. METHODS: An abdominal rectopexy carried out completely laparoscopically is described. The rectum is fully mobilised down to the pelvic floor and then fixed to the sacrum employing a polypropylene mesh. The mesh is first stapled to the sacral hollow and then sutured on both sides of the rectum. Thus the mesh is wrapped around the lateral aspects of the rectum, but the anterior rectal wall is left free. Laparoscopic techniques have been applied to a wide range of benign and malignant colorectal procedures. RESULTS: However most of colorectal laparoscopic techniques involving bowel resection, are technically demanding and require often an abdominal incision to deliver the specimen and fashion the anastomosis. CONCLUSIONS: Without the need for bowel resection, the laparoscopic rectopexy may constitute an optimal application of laparoscopic colorectal techniques and may soon become the gold standard for the treatment of rectal prolapse.

Humans↗
PubMed2006

Surgical excision of primary canine rectal tumors by an anal approach in twenty-three dogs.

OBJECTIVE: To describe an anal approach for excision of primary rectal tumors in dogs and to report outcome. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=23) with primary rectal tumors. METHODS: Review of medical records (1990-2000) of dogs with primary rectal neoplasia excised surgically using an anal approach with rectal prolapse. With dogs anesthetized, the rectum was prolapsed, stabilized with stay sutures during tumor excision with 1 cm margins to the level of the muscularis, then the rectal mucosa was sutured. RESULTS: Each dog had only 1 tumor type (adenocarcinoma [8], solitary polyp [5], carcinoma [4], plasmacytoma [2], adenoma [1], leiomyoma [1], mucinous carcinoma [1], and papilloma [1]). Mean tumor volume was 3.1 cm(3) (range 0.1-37.7 cm(3)). Postoperative complications (rectal bleeding [5], tenesmus [4]) were mild and resolved within 7 days after surgery; another dog had partial mucosal dehiscence identified at 6 days. The primary tumor was incompletely excised in 1 dog (4.3%), and local recurrence occurred 16 and 24 months after surgery in 2 dogs. Outcome beyond the immediate postoperative period was known for 18 dogs, including 2 dogs still alive. Mean postoperative disease-free interval for these 18 dogs was 36.8 months (range 5-84 months). CONCLUSION: Surgical excision of tumors of the caudal rectum can be accomplished through the anus after rectal prolapse. CLINICAL RELEVANCE: An anal approach facilitated by rectal prolapse should be considered as a viable option for the surgical treatment of selected cases of tumors of the caudal aspect of the rectum in dogs.

Adenocarcinoma↗
PubMed1994

[The functional and manometric results of 2 surgical methods of posterior abdominal rectopexy].

Functional changes after posterior abdominal rectopexy for the treatment of rectal prolapse are not fully understood. We studied the effects of Wells' or Ripstein's rectopexy on functional characteristics as related to anal sphincter function, rectal volume and sensory function in 31 patients with complete or internal rectal prolapse. We have observed an improvement of continence over 70% in both groups. However, an absent or a decreased call to stool, constipation and evacuation difficulties are the aftermath of Wells' rectopexy, while these complaints appear basically unaffected by Ripstein's technique. Maximal squeeze pressure was slightly increased after Ripstein's rectopexy, whereas no significant effects were found on anal pressures. Postoperatively the rectal capacity was reduced by Well's procedure (p < 0.05), while no significant changes were observed with Ripstein's operation. After the Wells procedure patients developed at the threshold for the relaxation of the internal sphincter progressively lower rectal volumes, reaching one year after rectopexy the statistical significance. Sensory thresholds for sense of filling and urge were significantly raised after Wells' rectopexy even one year after operation, whereas after Ripstein's operation sense of filling was not significantly affected and while sense of urge was increased early postoperatively, it was not significantly changed at one hear postoperative control. In conclusion, when fecal incontinence appears associated to a rectal prolapse has good chances to improve postoperatively. Preoperative evacuation difficulties seem to be unaffected by a posterior abdominal rectopexy, Wells or Ripstein, but an extensive dissection of the rectum with the division of the lateral stalks, as it is performed in Wells' operation, seems to be a procedure that can create a further burden of problems the the patient and it seems coupled to a manovolumetric elevation of rectal sensory thresholds.

Adult↗
PubMedDate not supplied

The use of prosthetic material in rectopexies.

Among the 80 different techniques that have been devised to repair rectal prolapse, abdominal rectopexies are the most suitable. The majority of these operations secure the rectum to the sacrum by means of a prosthetic material. Ripstein's technique, in USA, and Wells procedure, in Great Britain, have gained wide acceptance, despite a rather high rate of complications. A modified technique has been recently proposed by Keighley et al., with excellent results. From 1979 to 1982, 20 patients were operated upon in our department for rectal prolapse. The mean age of the patients was 43 years, and there was a rather high percentage of male patients (30%). Eleven exhibited an obvious external prolapse patients (30%). Eleven exhibited an obvious external prolapse but the others complained of the "occult rectal prolapse syndrome". The Orr-Loygue procedure, that secures the rectum to the sacral promontory by means of two strips of nylon mesh, was performed in all these cases. No mortality was observed and the morbidity was minimal. No infectious complications occurred. The procedure was performed without sexual consequences in the young patients. Clinical, endoscopic and cineradiographic checks illustrate that the Orr-Loygue rectopexy is an efficient treatment of both incipient intussusception and external prolapse, and offers good control of most associated troubles. But a longer survey is necessary before definitive conclusions may be drawn.

Adolescent↗
PubMed2000

Rupture of the rectosigmoid colon with evisceration of the small bowel through the anus.

Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.

Aged↗
PubMed1998

[The defecographic and clinical aspects of the solitary rectal ulcer syndrome].

INTRODUCTION: Solitary rectal ulcer syndrome is a complex evacuation disorder characterized by a benign ulcerative lesion of the distal rectum; the main symptom is rectal bleeding, but mucus discharge and difficult evacuation may be associated. The clinical, endoscopic and radiologic findings of solitary rectal ulcer syndrome are evaluated in this study. The role of defecography in the diagnosis of mucosal ulceration and morphofunctional alterations such as rectal prolapse and intussusception are investigated. MATERIAL AND METHODS: In the last 5 years, 27 patients (19 women and 8 men; mean age: 38 years; range: 13-70 years) complaining of obstructed evacuation and rectal bleeding were examined with fibrosigmoidoscopy with biopsy, and defecography combined with videoproctography. Defecography was carried out sitting the patients on a defecographic chair with the pelvis in lateral projection. The images were acquired at rest, under straining, during squeezing and evacuation. RESULTS: Endoscopy and biopsy showed 21 cases of solitary ulcer (77.8%), 3 cases of multiple ulcers (11.1%), 2 cases of granular proctitis (7.4%) and 1 case of pseudopolyp of rectum (3.7%). Among anorectal dynamic alterations, only 1 case (3.7%) of large rectocele was detected at endoscopy under straining. Histo-pathological changes were compared according to Rutter and Riddel criteria; the "colitis cystica profunda" appearance was observed in 2 cases (7.4%). Defecography showed 18 cases (16.6%) of solitary ulcer, 1 case (3.7%) of multiple ulcers and 2 cases (7.4%) of granular proctitis; but it missed 3 cases (11.1%) of small solitary ulcer, 2 cases (7.4%) of small multiple ulcers, and 1 case (3.7%) of pseudopolyp. The dynamic abnormalities shown by defecography were 11 cases (40.7%) of rectal intussusception, 7 cases (25.9%) of recto-anal intussusception, 6 cases (22.2%) of external rectal prolapse and 8 cases (29.6%) of mucosal prolapse. In 16 patients (59.2%) videoprotography emphasized how the ulcer wall was the first to take part in the invagination complex. CONCLUSIONS: Double contrast barium enema represents a useful radiologic method to diagnose solitary rectal ulcer, but air insufflation and pharmacological hypotonia prevent the functional study of rectal walls. Endoscopy permits to detect mucosal ulcerations, erythema, pseudopolyps and granular proctitis; biopsy provides an accurate diagnosis. We suggest combined defecography and videoproctography as a useful tool for evaluating solitary rectal ulcer syndrome as a whole; defecography is necessary to identify associated functional abnormalities, such as rectal prolapse and intussusception, not detectable by other instrumental and radiologic investigations and considered by many authors the likely cause of the disease.

Adolescent↗
PubMed1996

Inflammatory large bowel disease in immunodeficient mice naturally infected with Helicobacter hepaticus.

Large bowel disease detected clinically by rectal prolapse was studied in 64 immunodeficient mice (37 athymic NCr-nu/nu, 12 BALB/c AnNCr-nu/nu, 9 C57BL/6NCr-nu/nu, and 6 C.B17/Icr-scid/NCr) naturally infected with Helicobacter hepaticus. Rectal prolapse was found in approximately 5% of immunodeficient mice maintained in a research facility over a period of 3.5 years. All mice had various degrees of chronic proliferative typhlitis, colitis, and proctitis, usually without concomitant hepatitis. Some mice had severe proliferative proctitis with cystic hyperplasia. Histologic study of the large bowel of 48 athymic NCr-nu/nu mice without H. hepaticus infection and housed in another clean facility revealed only 12% of the mice with minimal-to-mild large bowel inflammation. Helicobacter hepaticus infection is associated with large bowel disease in immunodeficient mice but is not seen in H. hepaticus-infected immunocompetent mice. This new pathogenic bacterial infection should be considered as another potential cause or co-factor for rectal prolapse and large bowel disease in mice.

Animals↗
PubMed1990

[Solitary rectal ulcer syndrome: clinical features, clinical course and treatment. Apropos of 22 cases].

Rectopexy associated with anterior prolepsectomy was performed for 22 patients (19 females, 3 males), with solitary rectal ulcer syndrome (SRUS) surrounding internal rectal prolapse. The different lesions of SRUS were distributed among 3 main groups (G) according to the macroscopic appearance: G1: solitary ulcer (n = 7); G2: ulcerated proctitis (n = 7); G3: muco-hemorroidal prolapse (n = 3). A significant difference (P less than 0.05) was observed between each group, concerning mean age (G1: 34 years, G2 = 49, G3: 65) and the degree of perineal descent, which was more important in G3 and G2. Posterior intersphincteric rectopexy was performed for 6 patients in G3, with descending perineum and faecal incontinence, treated in the same time by perineoplasty (Parks). Abdominal rectopexy, mainly by the antero-posterior technique (Nicholls), was performed for the other patients (n = 6). Large anterior prolapsectomy reaching the top of the mucosal prolapse (4-7 cm), allowing ulcer resection in 3 cases, was combined with rectopexy. Associated operations were: sphincterotomy (n = 8) for narrow fibrous anal canal, sigmoidectomy (n = 4) for dolichocolon. Mean healing time for the solitary ulcer group (G1) was 2 months, 1 month for lesion of G2 and G3. Failures concerned 1 solitary ulcer after abdominal rectopexy and 1 ulcerative proctitis after rectopexy without prolapsectomy. Anorectal pain (81%), rectal bleeding (76%), faecal incontinence (27%), straining (81%), were cured or improved in 80% of cases. These results tend to confirm the efficacy of rectopexy, specially using the antero-posterior technique, for the treatment of SUSR with internal rectal prolapse. Nevertheless, rectopexy seems to be insufficient to correct the mucosal component of internal rectal prolapse, bearing the ulcerated lesion which needs to be treated by associated anterior prolapsectomy. Similarly all functional or organic disorders involving the perineum, anal canal or colon leading to anorectal dysfunction must also be considered to ensure complete treatment.

Adult↗
PubMed1984

Clinical and manometric features of the solitary rectal ulcer syndrome.

We report 33 patients with the solitary rectal ulcer syndrome seen between 1975 and 1982. Twenty-four were women and the median age was 32 years. The principal symptoms were bleeding (89 per cent), chronic constipation (64 per cent), rectal pain (42 per cent), tenesmus (42 per cent), and mucous discharge (45 per cent). Twenty-eight patients gave a history of straining (85 per cent). A full-thickness rectal prolapse was present in six patients, an anterior rectal prolapse was observed in 11, and 12 patients had clinical evidence of perineal descent. Defecation was only possible by digital evaluation in six women, and three male patients were passive homosexuals. Manometric studies were performed on 16 patients; eight patients were unable to tolerate rectal distention with 200 cc of air and impaired rectal sensation was present in two. Rectal distention was associated with bursts of involuntary external sphincter activity in three patients, and the distention reflex was absent in six, despite normal ganglia on rectal biopsy. In only four patients was there electromyographic evidence of contraction of the puborectalis during attempted defecation. Fourteen patients were treated by rectopexy; healing of the ulcer occurred in five of six with a full-thickness prolapse compared with only two of eight without a complete prolapse.

Adult↗
PubMedDate not supplied

Anterior modification of Delorme procedure provides equivalent results to Delorme procedure in treatment of rectal outlet obstruction.

BACKGROUND: This study was designed to assess the results of the standard Delorme procedure versus an anterior modification of the Delorme procedure in the treatment of patients with rectal outlet obstruction secondary to internal intussusception with or without rectocele. STUDY DESIGN: A descriptive retrospective study from October 1997 to May 2001 was undertaken. Twenty-seven patients with symptoms of rectal outlet obstruction assumed to be caused by internal rectal prolapse or a combination of internal rectal prolapse and rectocele underwent surgical repair. Twenty-two patients had preoperative defecography and anal manometry. Thirteen patients had an anterior Delorme repair; 14 patients had a standard Delorme repair. Selection of procedure was chronologic with the standard Delorme undertaken in the earlier group. Preoperative and operative data were collected retrospectively. RESULTS: Twenty-seven women, aged 29 to 94 (mean, 62.0 for anterior Delorme, 66.3 for Delorme) years were followed up for the duration of the study (mean follow-up, 15.9 months for anterior Delorme and 32.1 months for Delorme). Twelve patients (92.3%) reported a good to excellent overall result after the anterior Delorme procedure versus 14 patients (100%) in the Delorme group. Symptomatic improvement was observed in 85.7% of patients who had incomplete evacuation in the anterior Delorme group versus 90.9% in the Delorme group. Symptoms of constipation, bleeding, and the need to manually assist in defecation by pushing in the perineum or vagina improved in 100% of patients in both groups. Discontinuation of laxative use after the procedure was reported by 75% of patients in the anterior Delorme group versus 100% in the Delorme group. Eight patients experienced minor complications, 4 of these being urinary retention. In the postoperative period, no patients in the modified group experienced incontinence. Sixty three percent of the Delorme group experienced some sort of incontinence within the first 2 to 3 months (p = 0.038). CONCLUSIONS: An anterior modification of the Delorme procedure, which requires less operative dissection, can be performed with results nearly equivalent to those of the established Delorme procedure in the treatment of rectal outlet obstruction secondary to internal intussusception with or without rectocele.

Adult↗