Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram

Br J Surg. 1992 May;79(5):439-40. doi: 10.1002/bjs.1800790523.


Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine wire electromyography of the internal and sphincter (IAS), external and sphincter and puborectalis, together with anorectal manometry, using a computerized system. Examinations were performed both before and 3 to 4 months after rectopexy. The median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG) frequency was 0.18 (0.05-0.31) Hz and the median (i.q.r.) preoperative resting anal pressure was 28 (15-64) cmH2O. An improvement in the IAS EMG frequency, median (i.q.r.) 0.29 (0.19-0.38) Hz (P less than 0.03), and resting anal pressure, median (i.q.r.) 41 (20-72) cmH2O (P less than 0.05), was recorded after operation, but these variables remained significantly lower than those found in normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36-0.48) Hz and median (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent rectoanal inhibition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal / physiopathology*
  • Electromyography
  • Fecal Incontinence / physiopathology
  • Fecal Incontinence / surgery*
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Prospective Studies
  • Rectal Prolapse / physiopathology
  • Rectal Prolapse / surgery*
  • Rectum / surgery*