Rectal Prolapse.

Pelvic organ prolapse (POP) is a common condition among aging women, whereas rectal prolapse (RP) is uncommon. The change of anatomy and vector of downward force after surgical repair of POP may be a risk factor for RP. The objective of this study is to examine the occurrence of RP after surgical repair of POP and associated clinical factors. A retrospective chart review was performed from 2013 to 2024 for women who had undergone surgery for POP at a single institution. Demographic variables were analyzed. Correct diagnoses were validated, and clinical courses were extracted. Appropriate statistical analysis was performed. A total of 2381 surgeries for POP were performed (2150 reconstructive, 231 obliterative). Seven patients developed RP, 0.14% of patients who had undergonereconstructive surgery, and 1.7% in whom obliterative vaginal surgery had been performed. In univariate analysis, the odds of a patient being diagnosed with RP after reconstructive repair were 12 times lower than after an obliterative repair (OR 0.08, CI 0.012-0.48, p < 0.05). After adjusting for age, parity, and BMI, patients who had undergone obliterative surgical repair still showed higher odds of developing RP than those who had undergone reconstructive repair, although this finding did not reach statistical significance (OR 6.15, 95% CI 0.76-44.84, p = 0.09). This exploratory description of the finding of RP in patients who had undergone surgical repair of POP generates the hypothesis that there is a higher likelihood of the developing RP in patients who undergo obliterative vaginal repairs than in those who undergo reconstructive vaginal repairs. Further research is needed to elucidate this relationship.

Transanal Minimally Invasive Surgery (TAMIS) is a viable technique for local excision of rectal lesions, offering improved access, specimen quality and recurrence rates compared to traditional methods. While most published data are from tertiary centres, this study evaluates the outcomes of TAMIS performed at a regional New Zealand hospital. A retrospective analysis was conducted on all patients who underwent TAMIS at Tauranga Hospital between December 2014 and October 2025. Demographic, operative, histopathological, morbidity and 30-day mortality data were collected. Complications were classified using the Clavien-Dindo system. Sixty five patients (mean age 69; 69% male) underwent TAMIS over the study period. The mean resection size was 41 × 29 mm. Histological diagnoses included adenomas (n = 35), adenocarcinomas (n = 20), carcinoid tumour (n = 1), gastrointestinal stromal tumour (n = 2), benign scar tissue (n = 6) and rectal prolapse (n = 1). R0 resection was achieved in 97% of polyps and 85% of adenocarcinomas. The mean length of stay was 1.5 days. Complications of Clavien-Dindo grade II occurred in 11.0% and grade III in 6%, with postoperative haemorrhage being most common. One mortality occurred within 30 days postoperatively (1.6%). None of the adenocarcinoma patients developed recurrence; two (6%) patients had recurrent adenomas both successfully managed with local treatment. TAMIS can be performed safely and effectively in a regional centre, providing acceptable morbidity and mortality rates for a wide range of rectal pathologies.

Background: Complete rectal prolapse (RP) is a debilitating pelvic floor disorder often accompanied by obstructed defecation syndrome (ODS), fecal incontinence, and LARS-like bowel dysfunction. Laparoscopic resection rectopexy (LRR) is an established abdominal approach; however, functional outcomes after LRR with transanal specimen extraction (LRR-TSE) are incompletely defined. Aim: To evaluate short- and long-term functional outcomes—ODS, Wexner incontinence score (WIS), and LARS—in patients undergoing LRR-TSE. Methods: This single-center cohort included 53 consecutive patients who underwent LRR-TSE between January 2013 and December 2019. Variables were prospectively recorded and analyzed retrospectively. ODS, WIS, and LARS scores were assessed preoperatively and at 3, 6, and 12 months. Longitudinal changes were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction, polynomial contrasts when appropriate, and Bonferroni-adjusted pairwise comparisons. Results: ODS improved significantly over time (p < 0.001), decreasing from 12.8 ± 3.2 preoperatively to 2.4 ± 2.1, 4.2 ± 2.2, and 5.2 ± 2.9 at 3, 6, and 12 months, respectively. LARS scores declined from 18.0 ± 12.7 at 3 months to 8.8 ± 6.8 at 6 months and 3.5 ± 4.2 at 12 months (p < 0.001). WIS showed a transient increase at 3 months (8.1 ± 5.2), followed by improvement at 6 and 12 months (3.2 ± 3.7 and 2.4 ± 3.0; p < 0.001). Sex and body mass index did not affect functional trajectories (p > 0.05), whereas patients aged ≥50 years had higher postoperative LARS and WIS scores (p < 0.05). Complications occurred in 5 patients (9.43%), including one anastomotic leak with a mortality rate of 1.85%. Full-thickness recurrence occurred in 2 patients (3.77%), and 3 developed mucosal prolapse managed with Delorme’s procedure. Conclusions: LRR-TSE is a safe and feasible minimally invasive technique that improves constipation, continence, and LARS-related bowel dysfunction. Early postoperative impairment may overestimate long-term functional severity, highlighting the need for follow-up beyond 12 months.

Severe fecal incontinence predicts higher recurrence risk in complete rectal prolapse: a retrospective cohort study.

The posterior rectal advancement anoplasty (PRAA) is a novel approach for females with rectoperineal fistulas in which the distal fistula tract lies within the anterior limit of the anal sphincter complex. PRAA eliminates the risk of vaginal injury and perineal body dehiscence while allowing for an appropriately sized and centered anal opening. This study aims to examine the complications and outcomes following PRAA.A retrospective, single-institution study was performed of female patients with an anorectal malformation with a rectoperineal fistula between January 2020 and December 2023. PRAA was performed when the rectoperineal fistula was located within the anterior extent of the anal sphincteric ellipse. We assessed time to first feeding, length of stay, and early stooling patterns and complications.Twelve patients underwent PRAA at a median age of 171 days with a median follow-up of 5 months. None were previously diverted with an ostomy. There was no incidence of vaginal injury, wound dehiscence, rectal prolapse, or anal stricture. All were able to resume feeds immediately and were discharged home on postoperative day 1. On follow-up, all patients were stooling spontaneously, and nine (75%) were utilizing daily laxatives.The PRAA, specifically in female patients with rectoperineal fistula within the anterior limit of the sphincters, eliminates the risk of vaginal injury and perineal body dehiscence. This technique decreases the risk of rectal prolapse and anal stricture and allows patients to return to their regular diet and home quickly, after only 1 postoperative day. It can be done without the need for a colostomy. Longer-term data are needed to continue to explore functional outcomes.

Integrating Core Descriptors with Core Outcomes in Rectal Prolapse: A Patient-Centered Framework for Trials and Registries.

Functional results after ventral mesh rectopexy in 50 patients with obstructed defecation and/or fecal incontinence.

Background/Purpose: Rectal prolapse is a debilitating condition typically treated with surgery, yet some patients decline or are not candidates for operative intervention. Conservative management strategies are underreported, particularly in older adults. This case report describes the use of an integrative physical therapy approach, including pelvic floor muscle training, acupressure, and mindfulness-based interventions, in the nonsurgical management of rectal prolapse in an older adult. Case Description: A 71-year-old woman with chronic rectal prolapse, rectal and low back pain, urinary urgency, and functional limitations following bowel movements sought physical therapy after declining surgical intervention. Examination revealed pelvic floor muscle weakness, fascial restrictions, and symptom-related anxiety. A multimodal treatment plan included pelvic floor exercises, manual therapy, acupressure, breath training, and daily mindfulness practice. Outcomes: Over 7 visits, the patient reported a 90% reduction in prolapse severity based on self-rating. Rectal pain after bowel movements, rated 5/10 at baseline, was reduced to 0/10. Pelvic Floor Distress Inventory Questionnaire-20 scores improved from 220.83 to 84.28, exceeding the minimally important change threshold. She regained the ability to complete activities of daily living without post-defecation limitations and reported improved urinary control and functional mobility. Discussion: This case highlights the potential role of integrative physical therapy, including acupressure and mindfulness-based interventions, in the conservative management of rectal prolapse. The patient’s significant symptom relief and functional gains suggest that noninvasive, whole-person approaches may offer effective alternatives for select individuals. Further research is needed to evaluate implementation, outcomes, and standardization of these therapies in pelvic health rehabilitation.

Background: Complete rectal prolapse refers to the full-thickness extension of the rectal wall through the anus and is more prevalent in older adults, particularly women. Treatment primarily includes surgical correction, and there is still a discussion regarding the most effective one. Objective: This paper compares two laparoscopic methods, including laparoscopic posterior mesh rectopexy (LPMR) and laparoscopic posterior suture rectopexy (LPSR), in terms of recurrence rates and bowel functioning outcomes. Study Design: Randomized controlled trial. Settings: Department of Surgery, Khyber Teaching Hospital, Peshawar Pakistan. Duration: two years from December 2023 to November 2025. Methods: A total of seventy-seven patients were selected who had complete rectal prolapse at random to receive either LPMR or LPSR. Outcomes were recurrence, postoperative constipation scores, and fecal incontinence severity index (FISI) at 30 and 60 days in the postoperative period. Results: Both groups were demographically similar. The LPMR group had significantly lower recurrence rates (p = 0.004), shorter operative time (p &lt; 0.001), and improved bowel function, demonstrated by lower constipation (p &lt; 0.001) and FISI scores (p = 0.001). No significant differences were observed in postoperative pain, hospital stay, or intraoperative blood loss. Conclusion: LPMR appears to offer superior outcomes over LPSR in reducing prolapse recurrence and improving bowel function. Long-term follow-up is recommended to assess the durability and safety of mesh use.

To evaluate the efficacy of injection sclerotherapy in the management of reducible rectal prolapse (RP) in children. Children with reducible RP who underwent sclerotherapy with Kinurea-H® (quinine dihydrochloride/urea) were retrospectively included, and divided into 2 groups, functional RP (FRP) or organic RP (ORP). Thirty-two patients were included, 18 FRP and 14 ORP (7 anorectal malformation (ARM), 2 anorexia nervosa, 1 Hirschsprung disease, 2 spinal dysraphism, 1 Ehlers-Danlos, 1 short bowel syndrome) with a median age of 4 years. After one injection, the success rate was higher in FRP (78%) than in ORP (21%) (p = 0.0009). After 2-4 injections, success rate was 94% in FRP and 93% in ORP, with a minimal mucosal resection of the fixed portion (less than 5mm, limited to the ano-cutaneous junction) in 4/7 ARM. Repeated injections were performed at same site in all ORP without ARM, and in only 43% of ORP with ARM. Recurrence of reducible RP after the first injection at one site was associated with ORP (p = 0.03), particularly in ORP without ARM (p = 0.06). Sclerotherapy for reducible RP is efficient after failure of conservative management in FRP and success rate after repeated injections is encouraging in ORP, particularly in ARM.

Rectal prolapse is a common pelvic floor disorder. Its pathogenesis primarily involves the degeneration and impairment of the supporting tissues of the rectum, leading to their laxity and consequent displacement of the rectum. As the pelvic cavity is a complex system consisting of gynecology, urology, and coloproctology, rectal prolapse often coexists with other pelvic relaxation disorders, such as perineal descent, pelvic floor hernias, and uterovaginal prolapse. Traditionally, pelvic-related disciplines have operated independently, creating disciplinary boundaries that restricted perspectives to single specialties. This compartmentalization focuses narrowly on repairing specific anatomical structures while neglecting the integrity of the pelvic floor system, thereby hampering the diagnosis and comprehensive management of pelvic floor disorders. This is a key reason for the high recurrence rates and poor long-term outcomes associated with traditional surgical approaches. The Integral Theory Paradigm (ITP) views the pelvic floor as an indivisible functional unit, emphasizing pelvic floor dysfunction caused by laxity of muscles, fasciae, and ligaments. By providing an interdisciplinary theoretical foundation, it has significantly advanced systematic innovations in the research, diagnosis, and treatment of pelvic floor disorders. Since the 21st century, with the development of the Integral Theory and membrane anatomy, the adoption of autologous fascial ligament reconstruction techniques has brought new prospects for the surgical management of rectal prolapse.

Objective: To compare postoperative anal function recovery between laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis and laparoscopic total colectomy with ileorectal anastomosis for slow transit constipation. Methods: This multicenter retrospective cohort study enrolled patients meeting the following criteria: (1) severe constipation symptoms (<2 bowel movements/week), absent or insignificant defecation urge, abdominal distension, requiring laxatives to maintain bowel movements or laxatives being ineffective; (2) constipation symptoms for over 5 years, ineffective after >2 years of medical treatment, with strong desire for surgery; (3) significantly prolonged colon transit time (>72 hours) without significant gastric or small intestinal transit dysfunction; (4) no organic colonic lesions confirmed by colonoscopy and abdominal CT. Exclusion criteria: (1) patients undergoing open surgery; (2) exclusion of outlet obstruction constipation (e.g., rectocele, rectal prolapse, puborectalis spasm) by functional defecation MRI; (3) comorbid psychiatric disorders; (4) missing clinical data or loss to follow-up (postoperative follow-up <24 months). Based on these criteria, clinical and follow-up data were collected from 220 patients who underwent either laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSC group, n = 115) or laparoscopic total colectomy with ileorectal anastomosis (LTC group, n = 105) for slow transit constipation between January 2013 and December 2022. Subjective anal function (Constipation Severity Score and Wexner Fecal Incontinence Score) and objective anal function (positive rate of rectoanal inhibitory reflex [RAIR] and anorectal manometry) were observed preoperatively and at 6, 12, and 24 months postoperatively. Results: No significant differences were found in baseline characteristics between the two groups (all P >0.05). All surgeries were completed successfully without major significant complications. Subjective anal function assessment: At 24 months postoperatively, Constipation Severity Scores decreased significantly compared to preoperative scores in both groups [LSC group: (25.2±2.8) vs. (2.9±1.8), P <0.001; LTC group: (25.8±2.9) vs. (2.8±1.9), P<0.001]. No significant differences were found between the groups at 6, 12, and 24 months postoperatively (all P>0.05). Wexner Fecal Incontinence Scores at 24 months were significantly lower than those at 6 months in both groups [LSC group: (12.9±1.8) vs. (3.9±2.5), P<0.001; LTC group: (12.6±1.8) vs. (5.4±2.4), P<0.001]. Although no significant difference was found at 6 months (P = 0.190), the LSC group had significantly lower Wexner scores than the LTC group at 12 and 24 months postoperatively (both P < 0.001). Objective anal function assessment: (1) Positive RAIR rate: Preoperative positive RAIR rates were 33.0% (38/115) in the LSC group and 25.7% (27/105) in the LTC group (P > 0.05). At 24 months, positive rates increased significantly in both groups [LSC: 66.1% (76/115); LTC: 63.8% (67/105)] compared to preoperative rates (both P<0.001), but no significant differences were found between groups at 6, 12, and 24 months (all P>0.05). (2) Resting pressure (RP) and squeeze pressure (SP): No significant differences were found in preoperative RP and SP between groups (all P>0.05). The LSC group had significantly higher RP and SP than the LTC group at 6 and 12 months postoperatively (all P<0.05), but no significant differences were found at 24 months (P>0.05). Conclusion: Both laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis and laparoscopic total colectomy with ileorectal anastomosis are safe for patients with slow transit constipation. However, laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis offers superior postoperative anal function recovery.

Objective: To compare the clinical efficacy of laparoscopic pelvic floor autologous fascia integral repair based on membrane anatomy versus transperineal proctosigmoidectomy (Altemeier procedure) in the treatment of patients with complete rectal prolapse (CRP). Methods: This study employed a retrospective observational cohort design. Clinical data were collected from a total of 55 CRP patients who underwent surgical treatment between January 2018 and July 2023, including 25 patients from Luoyang Central Hospital, affiliated with Zhengzhou University, and 30 patients from the 989th Hospital of the Joint Logistics Support Force & Military Anorectal Surgery Research Institute. All patients undergoing surgery met the following criteria: aged ≥ 18 years, rectal prolapse protruding outside the anus, prolapse length > 5 cm with inability to self-reduce, conforming to the diagnostic criteria for CRP, and being first-time treated patients. Twenty-seven patients who underwent the Altemeier procedure between January 2018 and March 2021 were assigned to the Altemeier group; 28 patients who underwent laparoscopic pelvic floor autologous fascia integral repair based on membrane anatomy between April 2021 and July 2023 were assigned to the integral repair group. The therapeutic efficacy differences between the two groups were analyzed and compared, including the CRP length (DCRP), Wexner Constipation Score, Wexner Fecal Incontinence Score, and Gastrointestinal Quality of Life Index (GIQLI) before surgery and at 6, 12, and 24 months after surgery, as well as postoperative complications and recurrence at 24 months after surgery. Results: There were no statistically significant differences between the two groups in terms of gender distribution, age, preoperative body mass index (BMI), defecation frequency, DCRP, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI (all P>0.05). All patients completed the surgery. The length of hospital stay and intraoperative blood loss in the integral repair group were significantly less than those in the Altemeier group (both P<0.01). At 6, 12, and 24 months after surgery, the DCRP, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI in both groups significantly improved compared with the preoperative values (all P<0.001). At 6, 12, and 24 months after surgery, the CRP treatment effect, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI in the integral repair group were significantly better than those in the Altemeier group (χ²=15.821, P<0.001; χ²=18.238, P<0.001; χ² = 12.558, P=0.001; and χ² =22.413, P<0.001, respectively). In the integral repair group, 4 patients (14.3%) developed grade I-III postoperative complications, including 2 cases of urinary retention, 1 case of anastomotic bleeding, and 1 case of anastomotic stenosis. In the Altemeier group, 11 patients (40.7%) developed grade I-III postoperative complications, including 4 cases of urinary retention, 3 cases of anastomotic bleeding, 1 case of anastomotic stenosis, 2 cases of intestinal fistula, and 1 case of fecal incontinence. The difference between the two groups was statistically significant (χ²=4.850, P=0.028). There was no recurrence of CRP in the integral repair group at 24 months after surgery, while 7 cases of CRP recurrence were observed in the Altemeier group at 24 months after surgery. The difference between the two groups was statistically significant (χ²=6.148, P=0.013). Conclusion: The autologous fascia repair technique based on membrane anatomy and the pelvic floor integral theory is superior to the transperineal Altemeier procedure in the treatment of CRP. Furthermore, it is an effective surgical method for CRP.

In recent years, significant progress has been made in the treatment of chronic constipation, with high-quality studies emerging in areas such as fecal microbiota transplantation (FMT), sacral neuromodulation (SNM), acupuncture, and surgical techniques. The therapeutic approach is shifting from a traditional "medication and surgery" model toward an integrated strategy that includes dietary and defecation habit adjustment, FMT, SNM, acupuncture, pharmacotherapy, and surgery. Although FMT can partially improve stool frequency and consistency, its standardization and long-term efficacy require further validation. SNM demonstrates limited effectiveness in treating chronic constipation and is relatively cost-inefficient. Electroacupuncture remains controversial, though some studies support its value. Biofeedback therapy is recommended by multiple guidelines as the first-line treatment for dyssynergic defecation (DD), with portable home-based biofeedback systems showing considerable potential. For internal rectal prolapse (IRP) and rectocele (RC), various surgical options exist without a clear superiority, though laparoscopic ventral rectopexy (VMR) is increasingly favored due to its low recurrence rate and high patient satisfaction. In the surgical management of slow transit constipation (STC), total colectomy with ileorectal anastomosis remains the mainstream approach, while subtotal colectomy is gaining attention as an alternative.

Recurrent rectal prolapse (RRP) presents a significant clinical challenge due to the absence of standardized treatment guidelines and its impact on patients' quality of life. This retrospective study evaluates the outcomes of surgical management for RRP in a single-center cohort. We analyzed female patients (median age of 73) who underwent surgical treatment for RRP between 2014 and 2022. A total of 30 patients received either abdominal (n = 12) or perineal (n = 18) procedures, including ventral mesh rectopexy (VMR), resection rectopexy, Altemeier or Delorme techniques. Re-recurrence was more common following perineal procedures (39%) than abdominal approaches (25%). VMR and resection rectopexy demonstrated comparable success rates of 75%, while Altemeier and Delorme procedures showed 60% and 67% success, respectively. Functional outcomes improved significantly postoperatively, with the EQ-VAS quality of life score increasing from a median of 50 preoperatively to 75 at three years. Fecal incontinence and constipation scores (Wexner and CCCS) also showed marked improvement. Complications were minor and managed conservatively, with no cases of mesh erosion or anastomotic dehiscence reported. These findings support abdominal procedures, especially VMR and resection rectopexy, as the preferred treatment for medically fit patients with RRP. Perineal approaches remain viable for high-risk patients but are associated with higher recurrence. Although limited by its retrospective design, small sample size, and non-randomized treatment allocation, this study contributes valuable data to inform surgical decision-making in the management of RRP.

A Rare Cause of Solitary Large Rectal Mass and Diagnostic Dilemma: Rectal Mucosal Prolapse Syndrome.

Rationale:Anastomotic leakage represents the most critical complication following the Altemeier procedure. However, sepsis resulting from anastomotic leakage has been rarely reported in the literature.Patient concerns:A 53-year-old male with chronic obstructive pulmonary disease and rectal prolapse underwent the Altemeier procedure. On postoperative day 4, he developed sepsis secondary to anastomotic leakage.Diagnoses:The patient’s condition deteriorated after the Altemeier procedure, presenting with sepsis, anastomotic leakage, presacral infection, and acute exacerbation of chronic obstructive pulmonary disease.Interventions:Terminal ileostomy was performed, and a self-designed double-lumen irrigation-drainage catheter was placed at the anal anastomotic site for irrigation and drainage to control the source of infection. Concurrent intravenous antimicrobial therapy with meropenem and levofloxacin was administered.Outcomes:22 days after the terminal ileostomy procedure, procalcitonin and C-reactive protein levels normalized, and the patient was discharged. At the 4-month follow-up, colonoscopy revealed complete healing of the anastomosis, and successful ileostomy reversal surgery was subsequently performed.Lessons:For patients with rectal prolapse who have other comorbid infections or malnutrition, thorough preoperative assessment before the Altemeier procedure is crucial for preventing severe anastomotic leakage.

Psychiatric disorders are prevalent in patients with rectal prolapse. Although psychiatric disorders are associated with poor surgical outcomes and worse health in general, it is unknown how they impact rectal prolapse repair. To determine rectal prolapse symptom severity in patients with psychiatric disorders and how surgical repair modified these symptoms. Retrospective analysis of a prospectively maintained database. Academic colorectal practice. Female patients with and without psychiatric comorbidities who underwent rectal prolapse repair with preoperative and 1-year postoperative Pelvic Floor Distress Inventory (PFDI-20) scores. One-year change in PFDI-20 score. Of 365 female patients in our registry, 146 met the inclusion criteria. Fifty-four patients (36%) had a psychiatric disorder. Depression (66%) and anxiety (44%) were the most prevalent conditions. Patients with a psychiatric disorder were significantly younger (median age [interquartile range]: 61 years [48-67] vs 70 years [60-77], p < 0.001) but otherwise had a similar prevalence of comorbidities such as cardiac disease. Preoperative symptom profile was similar, but patients with psychiatric disorders reported higher PFDI-20 scores reflecting greater prolapse-related distress (mean [SD]: 146 [70] vs 115 [55], p = 0.01). Postoperatively, PFDI-20 scores improved significantly in both groups (adjusted mean change from baseline for patients with rectal prolapse repair: psychiatric disorders: -88 [-130 to -47] vs no psychiatric disorders: -44 [-68 to -19]). Models did not reveal a statistically significant differential improvement between groups, although patients with psychiatric disorders tended to have greater improvement in their scores compared to patients without psychiatric disorders. Single-center study with limited data on psychiatric comorbidity severity and disease control. Rectal prolapse patients with psychiatric disorders have prolapse-related distress at baseline but experience significant improvement after surgical repair, suggesting that appropriate management of rectal prolapse can improve their quality of life. The long-term durability of symptom improvement should be the focus of further work. See Video Abstract. ANTECEDENTES:Los trastornos psiquiátricos son frecuentes en pacientes con prolapso rectal. Si bien los trastornos psiquiátricos se asocian con malos resultados quirúrgicos y peor salud en general, se desconoce cómo afectan a la reparación del prolapso rectal.OBJETIVO:Determinar la gravedad de los síntomas del prolapso rectal en pacientes con trastornos psiquiátricos y cómo la reparación quirúrgica modificó estos síntomas.DISEÑO:Análisis retrospectivo de una base de datos mantenida de forma prospectiva.ENTORNO:Práctica académica colorrectal.PACIENTES:Pacientes mujeres con y sin comorbilidades psiquiátricas que se sometieron a una reparación de prolapso rectal con puntuaciones preoperatorias y postoperatorias al año en el Inventario de Distress del Suelo Pélvico (PFDI-20).MEDIDA DE RESULTADO PRINCIPAL:Cambio en la puntuación del PFDI-20 al cabo de un año.RESULTADOS:De las 365 pacientes de nuestro registro, 146 cumplían los criterios de inclusión. 54 (36 %) tenían un trastorno psiquiátrico. La depresión (66 %) y la ansiedad (44 %) fueron las afecciones más prevalentes. Las pacientes con un trastorno psiquiátrico eran significativamente más jóvenes (mediana [IQR] de edad: 61 [48, 67] frente a 70 [60,77], p < 0,001), pero por lo demás tenían una prevalencia similar de comorbilidades, como enfermedades cardíacas. El perfil de síntomas preoperatorios fue similar, pero los pacientes con trastornos psiquiátricos informaron puntuaciones PFDI-20 más altas, lo que refleja una mayor angustia relacionada con el prolapso (media [DE]: 146 [70] frente a 115 [55], p = 0,01). Después de la operación, las puntuaciones PFDI-20 mejoraron significativamente en ambos grupos (cambio medio ajustado con respecto al valor inicial para los pacientes con reparación de prolapso rectal: trastornos psiquiátricos: -88 [-130, -47] frente a sin trastornos psiquiátricos: -44 [-68, -19]). Los modelos no revelaron una mejora diferencial estadísticamente significativa entre los grupos, aunque los pacientes con trastornos psiquiátricos tendieron a presentar una mayor mejora en sus puntuaciones en comparación con los pacientes sin trastornos psiquiátricos.LIMITACIONES:Estudio de un solo centro con datos limitados sobre la gravedad de la comorbilidad psiquiátrica y el control de la enfermedad.CONCLUSIONES:Los pacientes con prolapso rectal y trastornos psiquiátricos sufren angustia relacionada con el prolapso en la línea de base, pero experimentan una mejora significativa después de la reparación quirúrgica, lo que sugiere que el tratamiento adecuado del prolapso rectal puede mejorar su calidad de vida. La durabilidad a largo plazo de la mejora de los síntomas debe ser el centro de atención de futuros trabajos. ( AI-generated translation ).

Minimally invasive ventral rectopexy for vaginal enterocele Treatment: A multicentric study.