Puborectoplasty in the Treatment of Complete Rectal Prolapse

Twenty patients with complete rectal prolapse were divided into 2 equal groups and subjected to clinical examination, barium enema and colonoscopy. Of group A, 2 patients were fully continent, 3 incontinent to flatus, 1 to liquid stool and 4 to solid stool. Three patients of group B were fully continent, 1 incontinent to flatus, 2 to liquid stool and 4 to solid stool. Group A was subjected to Shank’s puborectoplasty and followed up for 8-20 months. No recurrences were recorded; mucosal prolapse occurred in 1 patient. The patients who were incontinent to flatus and liquid stool preoperatively, became fully continent. The patients who were incontinent to solid stool became fully continent except for 1 who remained incontinent to liquid stool and 2 others who remained occasionally incontinent to flatus. 50% of the patients with preoperative constipation improved significantly. Group B patients underwent simple suture rectopexy. A follow-up of 8-20 months revealed: 1 complete recurrence, 2 mucosal prolapses, 1 incisional hernia and 1 patient with sinus formation; in all cases operative intervention was needed. In addition, intraoperative blood transfusion was indicated in 2 patients. Deep venous thrombosis of the femoral vein occurred in 1 patient. Three patients remained incontinent to stool (2 to solid, 1 to liquid), 2 became only incontinent to flatus and 4 fully continent. The problem of constipation remained.