Incontinence in full-thickness rectal prolapse: low level of improvement after laparoscopic rectopexy. - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Colorectal Disease Année : 2013

Incontinence in full-thickness rectal prolapse: low level of improvement after laparoscopic rectopexy.

Résumé

AIM: The study aimed to quantify incontinence before and after laparoscopic rectopexy in patients suffering from rectal prolapse. METHOD: Eighty-five patients underwent laparoscopic rectopexy to treat rectal prolapse between 2003 and 2009. Symptomatic and functional data were collected prospectively before and after surgery by self-administered questionnaires including the Cleveland Clinic Fecal Incontinence Score (CCIS) and constipation, gastrointestinal quality of life and urinary incontinence questionnaires. Incontinence was considered to be present when the CCIS remained at ≥ 5 after surgery. RESULTS: After a mean follow-up period of 36 months after surgery, 83% of the patients reported good to excellent results. Continence was improved in 58 (68%), with a significant decrease in the continence score (-3.4 ± 5.8, P = 0.001). However, 50 (58.9%) patients remained incontinent: 47 (55%) reported urge incontinence and 27 (32%) had passive leakage. Incontinence for liquid stool, incontinence for solid stool and the need for protection was seen in 43 (51%), 35 (41%) and 43 (51%) patients. Manometry, defaecography and ultrasonography were not associated with any improvement. In contrast, the patients' average age (60.2 ± 15.8 vs 46.9 ± 15.5 years; P = 0.003), symptom duration before surgery (58.1 ± 70.1 vs 29.5 ± 33.3 months; P = 0.011), preoperative urinary incontinence score (10.7 ± 10.8 vs 4.2 ± 5.7; P = 0.0131) and faecal incontinence score (12.9 ± 4.9 vs 7.1 ± 6; P < 0.0001) were significantly higher in patients suffering from postoperative incontinence. CONCLUSION: Despite some continence improvement in two-thirds of patients who underwent surgery for rectal prolapse, the level of improvement remained low in more than half of the patients.

Dates et versions

inserm-00841783 , version 1 (05-07-2013)

Identifiants

Citer

Diane Cunin, Laurent Siproudhis, Véronique Desfourneaux, Pierre-Yves Bouteloup, B. Meunier, et al.. Incontinence in full-thickness rectal prolapse: low level of improvement after laparoscopic rectopexy.. Colorectal Disease, 2013, 15 (4), pp.470-6. ⟨10.1111/codi.12027⟩. ⟨inserm-00841783⟩
191 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More