New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse

Tech Coloproctol. 2016 Feb;20(2):101-7. doi: 10.1007/s10151-015-1395-1. Epub 2015 Nov 20.


Background: This study was designed to assess defecatory function in patients who underwent laparoscopic ventral rectopexy (LVR) for external rectal prolapse (ERP).

Methods: Thirty-one patients who underwent evacuation proctography 6 months postoperatively were assessed. Preoperative proctography had been performed in 21 patients of these patients. Defecatory function was evaluated using the constipation scoring system (CSS) and fecal incontinence severity index (FISI).

Results: The findings of postoperative proctography revealed no full-thickness ERP in any patient, although in 10 patients the ERP was replaced by rectoanal intussusception (RAI). Of the 31 patients, 30 presented with fecal incontinence preoperatively. Ten of 30 had new-onset RAI. Six months postoperatively, a reduction of at least 50 % in the FISI score of the patients with new-onset RAI tended to be significantly smaller than in the patients without RAI (6/10 vs. 18/20, p = 0.141). Seventeen patients presented with obstructed defecation preoperatively. Seven of them had new-onset RAI. Six months postoperatively, a reduction of at least 50 % in their CSS score in the patients with new-onset RAI was significantly smaller than in patients without RAI (0/7 vs. 8/10, p = 0.002).

Conclusions: Evacuation proctography showed new-onset RAI in some patients with ERP who underwent LVR, which was associated with a lack of symptomatic improvement.

Keywords: Evacuation proctography; External rectal prolapse; Laparoscopic ventral rectopexy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Constipation / diagnostic imaging
  • Constipation / etiology
  • Defecation / physiology
  • Defecography / methods
  • Digestive System Surgical Procedures / methods
  • Fecal Incontinence / diagnostic imaging
  • Fecal Incontinence / etiology
  • Female
  • Humans
  • Intussusception / etiology*
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Rectal Diseases / etiology*
  • Rectal Prolapse / complications
  • Rectal Prolapse / diagnostic imaging
  • Rectal Prolapse / physiopathology
  • Rectal Prolapse / surgery*
  • Retrospective Studies
  • Severity of Illness Index