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Rectal prolapse

Etienne W Henn, Hennie S Cronje
INTRODUCTION AND HYPOTHESIS: A rectocele is the bulging of the anterior rectal wall into the posterior vaginal compartment. The route of surgical repair can be transvaginal, transrectal or abdominal. The aim of this retrospective study is to describe a novel transvaginal surgical procedure and investigate the associated subjective and objective clinical outcomes. METHODS: Database records were retrieved for all women who underwent a rectocele plication for the period from January 2010 until December 2015 in a referral urogynecology unit with a minimum follow-up period of 12 months...
March 12, 2018: International Urogynecology Journal
Tatiana Catanzarite, Daniel D Klaristenfeld, Marco J Tomassi, Gisselle Zazueta-Damian, Marianna Alperin
BACKGROUND: Pelvic organ prolapse is prevalent among women with rectal prolapse. OBJECTIVE: This study aimed to determine whether clinically significant pelvic organ prolapse impacts rectal prolapse recurrence after surgical repair. DESIGN: A retrospective cohort. SETTING: This study was performed at a single managed-care institution. PATIENTS: Consecutive women undergoing rectal prolapse repair between 2008 and 2016 were included...
March 8, 2018: Diseases of the Colon and Rectum
Brinda Bhatt, Peng Zeng, Huabin Zhu, Sathish Sivaprakasam, Siyi Li, Haiyan Xiao, Lixin Dong, Pamela Shiao, Ravindra Kolhe, Nikhil Patel, Honglin Li, Daniel Levy-Bercowski, Vadivel Ganapathy, Nagendra Singh
A set of coordinated interactions between gut microbiota and the immune cells surveilling the intestine play a key role in shaping local immune responses and intestinal health. Gpr109a is a G protein-coupled receptor expressed at a very high level on innate immune cells and previously shown to play a key role in the induction of colonic regulatory T cells. In this study, we show that Gpr109a-/- Rag1-/- mice exhibit spontaneous rectal prolapse and colonic inflammation, characterized by the presence of an elevated number of IL-17-producing Rorγt+ innate lymphoid cells (ILCs; ILC3)...
March 7, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Imad El Moussaoui, Augustin Limbga, Manke Dika, Abdelilah Mehdi
Introduction Rectal prolapse is the complete protrusion of the rectum through the anal canal, incarceration rarely complicates rectal prolapse. Even more rarely, it becomes strangulated and gangrenous, necessitating emergency surgery. Case presentation We present the first reported case of strangulated acute rectal prolapse as the first manifestation of rectal prolapse. The patient was a 26-year-old man who presented with a 20×6 cm semi-spherical mass extra-anally. Rectosigmoidectomy with sacral rectopexy was performed, resecting 20 cm of the incarcerated rectum and sigmoid colon...
January 1, 2018: Scottish Medical Journal
G Tsoucalas, T G Papaioannou, G V Papatheodoridis, M Karamanou
Known since antiquity, rectal prolapse was first studied systematically by Hippocrates (460-377 BC) who recognized the predisposing factors and proposed several therapeutic approaches such as defecation positions, manual retraction and specific herbal or mineral based anti-haemorrhagic and pain-killing poultices. Hippocratic medicine avoided invasive surgical procedures probably due to a lack of knowledge in human anatomy. However, Hippocrates' views astonishingly lasted in time, presenting similarities to current medical theories on rectal prolapse...
July 2017: Acta Gastro-enterologica Belgica
V Piloni, M Bergamasco, G Melara, P Garavello
BACKGROUND: The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic resonance (MR) defecography in males with obstructed defecation syndrome (ODS). METHODS: Thirty-six males with ODS who underwent MR defecography at our institution between March 2013 and February 2016 were asked in a telephone interview about their symptoms and subsequent treatment, either medical or surgical. Patients were divided into 2 groups, one with anismus (Group 1) and one with prolapse without anismus (Group 2)...
March 6, 2018: Techniques in Coloproctology
Tomohide Hori, Daiki Yasukawa, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Yuki Aisu, Yusuke Kimura, Yuichi Takamatsu, Taku Kitano, Tsunehiro Yoshimura
Full-thickness rectal prolapse (FTRP) is generally believed to result from a sliding hernia through a pelvic fascial defect, or from rectal intussusception. The currently accepted cause is a pelvic floor disorder. Surgery is the only definitive treatment, although the ideal therapeutic option for FTRP has not been determined. Auffret reported the first FTRP surgery using a perineal approach in 1882, and rectopexy using conventional laparotomy was first described by Sudeck in 1922. Laparoscopy was first used by Bermann in 1992, and laparoscopic surgery is now used worldwide; robotic surgery was first described by Munz in 2004...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
A C Rogers, N McCawley, A M Hanly, J Deasy, D A McNamara, J P Burke
PURPOSE: Rectal prolapse is a common condition, with conflicting opinions on optimal surgical management. Existing literature is predominantly composed of case series, with a dearth of evidence demonstrating current, real-world practice. This study investigated recent national trends in management of rectal prolapse in the Republic of Ireland (ROI). METHODS: This population analysis used a national database to identify patients admitted in the ROI primarily for the management of rectal prolapse, as defined by the International Classification of Diseases, 10th Revision (ICD-10)...
March 3, 2018: International Journal of Colorectal Disease
John H T Waldhausen, Morgan Richards
Cystic fibrosis is one of the most common inheritable traits in Caucasians. Meconium ileus and its potential complications are the most likely reasons that these patients will need surgical care. Surgical intervention is usually needed in the neonatal period but may also be required later in life. This article discusses the various ways cystic fibrosis can affect the gastrointestinal tract. Both the operative and nonoperative management of complicated and uncomplicated meconium ileus are discussed in the neonatal period as well as long-term issues, such as distal intestinal obstructive syndrome, fibrosing colonopathy, and rectal prolapse, all of which may be seen in older children and adults...
March 2018: Clinics in Colon and Rectal Surgery
Rebecca M Rentea, Shawn D St Peter
Rectal prolapse is a common and self-limiting condition in infancy and early childhood. Most cases respond to conservative management. Patients younger than 4 years with an associated condition have a better prognosis. Patients older than 4 years require surgery more often than younger children. Multiple operative and procedural approaches to rectal prolapse exist with variable recurrence rates and without a clearly superior operation. These include sclerotherapy, Thiersch's anal cerclage, Ekehorn's rectopexy, laparoscopic suture rectopexy, and posterior sagittal rectopexy...
March 2018: Clinics in Colon and Rectal Surgery
S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
February 22, 2018: International Journal of Colorectal Disease
Hans Peter Dietz, Mariángeles Gómez, Ixora Kamisan Atan, Caroline S Wanderley Ferreira
INTRODUCTION AND HYPOTHESIS: Rectocele is common in parous women but also seen in nulliparae. This study was designed to investigate the association between vaginal parity and descent of the rectal ampulla/rectocele depth as determined by translabial ultrasound (TLUS). METHODS: This retrospective observational study involved 1296 women seen in a urogynaecological centre. All had undergone an interview, clinical examination and 4D ultrasound (US) imaging supine and after voiding...
February 20, 2018: International Urogynecology Journal
Sophie V Goodall, Sathya K Chinnadurai, Toni Kwan, Copper Aitken-Palmer
A 13-y-old, multiparous female black-crested mangabey (Lophocebus aterrimus) underwent surgical treatment for chronically recurring rectal prolapse by laparotomy and subsequent colopexy. Initially, a laparoscopic approach was attempted but was converted to an open approach after intraabdominal adhesions were noted. The colopexy was performed through a ventral midline incision, with no complications intraoperatively or postoperatively. The predisposing factors responsible for the development of this condition likely were related to pelvic floor weakness due to multiple past pregnancies...
February 1, 2018: Comparative Medicine
Hirokazu Honda, Kenji Nakamura, Naoki Ishii, Koyu Suzuki, Katsuyuki Fukuda
A 37-year-old man presented to our hospital for early rectal cancer accompanied by mucosal prolapse syndrome. Biopsy confirmed an adenocarcinoma, and endoscopic ultrasonography indicated proximity to the dentate line but no submucosal invasion. The tumor was removed en bloc via endoscopic submucosal dissection without complications, and its margin was free of tumor cells. The total procedure duration was 37 minutes, and the resected specimen measured 23 × 13 mm. There was no recurrence during the 3-year observation period...
2018: ACG Case Reports Journal
Vandana Tripathi, Sohier Elneil, Lauri Romanzi
INTRODUCTION AND HYPOTHESIS: There is a need for expanded access to safe surgical care in low- and middle-income countries (LMICs) as illustrated by the report of the 2015 Lancet Commission on Global Surgery. Packages of closely-related surgical procedures may create platforms of capacity that maximize impact in LMIC. Pelvic organ prolapse (POP) and genital fistula care provide an example. Although POP affects many more women in LMICs than fistula, donor support for fistula treatment in LMICs has been underway for decades, whereas treatment for POP is usually limited to hysterectomy-based surgical treatment, occurring with little to no donor support...
February 6, 2018: International Urogynecology Journal
Ugo Grossi, Natasha Stevens, Eleanor McAlees, Jon Lacy-Colson, Steven Brown, Anthony Dixon, Gian Luca Di Tanna, S Mark Scott, Christine Norton, Nadine Marlin, James Mason, Charles H Knowles
BACKGROUND: Laparoscopic ventral mesh rectopexy (LVMR) is an established treatment for external full-thickness rectal prolapse. However, its clinical efficacy in patients with internal prolapse is uncertain due to the lack of high-quality evidence. METHODS: An individual level, stepped-wedge randomised trial has been designed to allow observer-blinded data comparisons between patients awaiting LVMR with those who have undergone surgery. Adults with symptomatic internal rectal prolapse, unresponsive to prior conservative management, will be eligible to participate...
February 5, 2018: Trials
Ryusei Yamamoto, Yasuji Mokuno, Hideo Matsubara, Hirokazu Kaneko, Shinsuke Iyomasa
BACKGROUND: Rectal cancer with rectal prolapse is rare, described by only a few case reports. Recently, laparoscopic surgery has become standard procedure for either rectal cancer or rectal prolapse. However, the use of laparoscopic low anterior resection for rectal cancer with rectal prolapse has not been reported. CASE PRESENTATION: A 63-year-old Japanese woman suffered from rectal prolapse, with a mass and rectal bleeding for 2 years. An examination revealed complete rectal prolapse and the presence of a soft tumor, 7 cm in diameter; the distance from the anal verge to the tumor was 5 cm...
February 6, 2018: Journal of Medical Case Reports
F-F Ai, L Zhu, M Mao, Y Zhang, J Kang
OBJECTIVE: This study aimed to investigate the impact of depressive symptoms on successful pessary treatment for postmenopausal women with symptomatic pelvic organ prolapse (POP). METHODS: We performed a prospective study involving postmenopausal women with POP who visited our clinic seeking pessary treatment. Demographic information and medical histories were collected. The participants completed the following questionnaires at baseline and after 3 months of successful pessary use: (1) the Pelvic Floor Impact Questionnaire-7 (PFIQ-7); (2) the Pelvic Floor Distress Inventory (PFDI-20); and (3) the Patient Health Questionnaire-9 (PHQ-9)...
February 3, 2018: Climacteric: the Journal of the International Menopause Society
B Trilling, P-Y Sage, F Reche, S Barbois, P-A Waroquet, J-L Faucheron
OBJECTIVE OF THE STUDY: Ventral rectopexy can be performed robotically with only limited trauma for the patient, making its performance in an ambulatory setting potentially interesting. The aim of this study is to report our preliminary experience with ambulatory robotic ventral rectopexy in consecutive patients. PATIENTS AND METHODS: Ten consecutive patients underwent robotic ventral rectopexy for total rectal prolapse (n=8) or symptomatic enterocele (n=2) between February 2014 and April 2015...
January 26, 2018: Journal of Visceral Surgery
Michihiro Koizumi, Takeshi Yamada, Seiichi Shinji, Yasuyuki Yokoyama, Goro Takahashi, Masahiro Hotta, Takuma Iwai, Keisuke Hara, Kohki Takeda, Hayato Kan, Hideaki Takasaki, Keiichiro Ohta, Eiji Uchida
Primary small intestinal volvulus is defined as torsion in the absence of congenital malrotation, band, or postoperative adhesions. Its occurrence as an early postoperative complication is rare. A 40-year-old woman presented with rectal prolapse, and laparoscopic rectopexy was uneventfully performed. She could not have food on the day after surgery. She started oral intake on postoperative day 3 but developed abdominal pain after the meal. Contrast-enhanced CT revealed torsion of the small intestinal mesentery...
February 1, 2018: Asian Journal of Endoscopic Surgery
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