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Results for “RECTAL PROLAPSE”

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PubMedDate not supplied

Cryosurgical treatment of hemorrhoids in Japan.

Hemorrhoid treatment in Japan consists mainly of conservative therapy and conventional surgery. Cryosurgical hemorrhoidectomy, though still not widely used, has attained a reputation for low profile surgery and relatively painless recovery compared to conventional surgery, in spite of some inevitable problems. Our series includes external hemorrhoids and prolapse, which have been ruled out from the indications for cryosurgery, yet obtained satisfactory results. A threatening drawback is lower digestive tract hemorrhage, which occurred in 19 of 372 prolapse patients (5.1%) after cryosurgery. As for its pathogenesis, an autoimmune reaction at the site of the terminal ileum is postulated. Characteristics of the hemorrhage are: onset around the 14th postoperative day at night or early in the morning, and seen particularly in nervous patients. Prophylactic administration orally of covering materials may reduce incidence. Cryosurgery is certainly an effective measure for the treatment of hemorrhoids, including prolapse.

Adolescent↗
PubMed1987

Endocrine cells in the human colorectal mucosa: immunocytochemical observations on patients with prolapse or internal procidentia of the rectum.

We have examined the occurrence and distribution of endocrine cells storing serotonin and the regulatory peptides somatostatin, glicentin, peptide YY in rectal mucosa on 16 patients with prolapse or intussusception of the rectum. There were no significant differences compared with normal rectal mucosa. Our results do not support the assumption that these endocrine cells of the rectum are involved in the pathophysiology of rectal prolapse.

APUD Cells↗
PubMedDate not supplied

Magnetic resonance imaging of pelvic organ prolapse.

Magnetic resonance imaging (MRI) of pelvic organ prolapse is technically feasible and has several advantages when compared with fluoroscopic cystoproctography. Organ descent and the supportive structures of the pelvic floor can be assessed with MRI. The role of MRI in evaluating patients with pelvic floor dysfunction is evolving, and there have been many developments in the past few years. The current status of MRI of pelvic organ prolapse is reviewed.

Contrast Media↗
PubMed1984

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. Treatment of hemorrhoids: report of a technique.

A technique for the treatment of hemorrhoids has been presented. It is based on a recent study in which the persistence of the anorectal band, a remnant of the anorectal sinus, and failure of rectal neck remodeling are considered responsible for the initiation of the hemorrhoid disease. The constricting effect of the anorectal band on the rectal neck results in elevation of its pressure, straining at defecation, and prolapse of the rectal mucosa. There were 502 patients with third and fourth degree hemorrhoids. The preoperative rectal neck pressure was high in all of them. The technique comprises division of the anorectal band and hemorrhoid ligation. The results were satisfactory, and the complications were negligible. The rectal neck pressure was normalized and straining disappeared. The procedure is simple and easy. Compared with the other techniques for hemorrhoid treatment, it offers the advantage of dealing with the primary etiologic factor.

Adult↗
PubMed1980

Solitary rectal ulcer syndrome: radiologic manifestations.

The solitary rectal ulcer syndrome is a distinct clinical entity occurring mainly in young patients who experience rectal bleeding. Solitary, and occasionally multiple, ulcers occur predominantly on the anterior or anterolateral aspects of the rectum. Current theories attribute this to pelvic muscle discoordination during defecation with partial rectal mucosal prolapse and traumatic ulceration. Classical histologic changes have been demonstrated that enable accurate diagnosis by the pathologist. Ten cases of biopsy-proven solitary rectal ulcer syndrome were reviewed. The radiographic abnormalities were: nodularity of the rectal mucosa (three cases), stricture formation (two cases), polypoid rectal masses (two cases), and ulceration (two cases). Radiologically this condition must be differentiated from other more serious entities such as carcinoma or inflammatory bowel disease.

Adolescent↗
PubMed1993

Defecography: principles of technique and interpretation.

After description of the performance, physiology and normal findings of defecography, the main pathology is discussed as intra-anal rectal intussusception, extra-anal rectal intussusception, mucosal prolapse, rectocele, descending perineum syndrome, spastic pelvic floor syndrome and the solitary rectal ulcer syndrome. Finally, the radiation dose and pitfalls are reported.

Defecation↗
PubMed1995

[Surgical abdominal access for prolapse using a Vicryl composite lattice. Preliminary study].

OBJECTIVE: Promontory fixation is a reliable technique for genitourinary prolapsus. Results obtained with Mersurtures are good, but infectious episodes have been described and the fixation is rigid. The pelvic organs loose their mobility with possible functional impairment. To avoid these problems, we tested a composite implant composed of 60% absorbable polyglactine 910 (Vicryl) and 40% non-absorbable terephthalic polyester (Dacron). SUBJECTS AND METHODS: A series of 32 patients with genito-urinary prolapsus were treated by one operator using the new material. Promontory fixation was performed in all cases, with at least one implant. The patients were followed for mean 24.2 months for evaluation of tolerance to the new material and the functional impact. These parameters were compared retrospectively with former experience with Mersutures. RESULTS: The new material was perfectly tolerated and no infectious complication was observed. The anatomic results were identical to those obtained with the Mersutures, giving 93.4% good anatomic results, 68% cure rate for urinary incontinence and 20% major improvement in urinary incontinence. It was difficult to analyse results for sexual activity and digestive tract function. CONCLUSION: The Vicryl composite is useful for promontory fixation in patients with prolapsus. This material which reduces the amount of inert material remaining in the form of a thin lattice of highly flexible Dacron, should be tested prospectively to determine the functional benefit of prolapsus care.

Adult↗
PubMed2006

A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'.

OBJECTIVE: Surgical treatment of constipation and obstructed defecation (OD) carries frequent recurrences, as OD is an 'iceberg syndrome' characterized by 'underwater rocks' or occult diseases which may affect the outcome of surgery. The aim of this study was to evaluate occult disorders in order to alert the clinician of these and minimize failures. METHOD: One hundred consecutive constipated patients with OD symptoms, 81 female patients, median age 52 years, underwent perineal examination, proctoscopy, anorectal manometry, and anal/vaginal ultrasound. Anorectal physiology and imaging tests were also carried out when indicated, as well as psychological and urogynaecological consultation. Symptoms were graded using a modified 1-20 constipation score. Both evident (e.g. rectocele) and occult (e.g. anismus) diseases were prospectively evaluated using a novel 'iceberg diagram'. The type of treatment, whether conservative or surgical, was also recorded. RESULTS: Fifty-four (54%) patients had both mucosal prolapse and rectocele. All patients had at least two occult OD-related diseases, 66 patients had at least three: anxiety-depression, anismus and rectal hyposensation were the most frequent (66%, 44% and 33% respectively). The median constipation score was 11 (range 2-20), the median number of 'occult disorders' was 5 (range 2-8). Conservative treatment was carried out in most patients. Surgery was carried out in 14 (14%) patients. CONCLUSION: The novel 'iceberg diagram' allowed the adequate evaluation of OD-related occult diseases and better selection of patients for treatment. Most were managed conservatively, and only a minority were treated by surgery.

Adult↗