Results of treatment for rectal prolapse and fecal incontinence

Abstract

Fifty-six patients were treated for rectal prolapse or incontinence. Rectal prolapse was present in 32 patients and was associated with fecal incontinence in 24 (75%). Incontinence without prolapse was present in 24 patients, 12 of whom were < 40 yr old. Rectopexy was used for treatment of rectal prolapse. Surgical treatment of fecal incontinence was by postanal repair; external sphincter reconstruction and surgery was advised only if control of diarrhea and electrical therapy had been of no benefit. Rectopexy was completely successful at controlling rectal prolapse in all cases and only 4 of the 20 patients (20%) with incontinence and prolapse remained incontinent after rectopexy alone. Incontinence was completely controlled by postanal repair in 58% of patients and by external sphincter repair alone or in combination with postanal repair in 67%. Using a combination of therapies 45 of 48 patients who were initially incontinent were improved (94%) and 42 of the patients have complete control of defecation (87%).