Introduction:Rectal prolapse is a condition that occurs infrequently in men and there is little literature guiding treatment in this population.The purpose of this study was to evaluate the surgical approach and outco...Introduction:Rectal prolapse is a condition that occurs infrequently in men and there is little literature guiding treatment in this population.The purpose of this study was to evaluate the surgical approach and outcomes of rectal-prolapse repair in men.Methods:A retrospective multicenter review was conducted of consecutive men who underwent rectal-prolapse repair between 2004 and 2014.Surgical approaches and outcomes,including erectile function and fecal continence,were evaluated.Results:During the study period,58 men underwent rectal-prolapse repair and the mean age of repair was 52.7624.1 years.The mean follow-up was 13.2 months(range,0.5–117 months).The majority of patients underwent endoscopic evaluation(78%),but few patients underwent anal manometry(16%),defecography(9%)or ultrasound(3%).Ten patients(17%)underwent biofeedback/pelvic-floor physical therapy prior to repair.Nineteen patients(33%)underwent a perineal approach(most were perineal proctosigmoidectomy).Thirty-nine patients(67%)underwent repair using an abdominal approach(all were suture rectopexy)and,of these,77%were completed using a minimally invasive technique.The overall complication rate was 26%including urinary retention(16%),which was more common in patients undergoing the perineal approach(32%vs.8%,P=0.028),urinary-tract infection(7%)and wound infection(3%).The overall recurrence rate was 9%,with no difference between abdominal and perineal approaches.Information on sexual function was missing in the majority of patients both before and after surgery(76%and 78%,respectively).Conclusion:Rectal-prolapse repair in men is safe and has a low recurrence rate;however,sexual function was poorly recorded across all institutions.Further studies are needed to evaluate to best approach to and functional outcomes of rectal-prolapse repair in men.展开更多
文摘Introduction:Rectal prolapse is a condition that occurs infrequently in men and there is little literature guiding treatment in this population.The purpose of this study was to evaluate the surgical approach and outcomes of rectal-prolapse repair in men.Methods:A retrospective multicenter review was conducted of consecutive men who underwent rectal-prolapse repair between 2004 and 2014.Surgical approaches and outcomes,including erectile function and fecal continence,were evaluated.Results:During the study period,58 men underwent rectal-prolapse repair and the mean age of repair was 52.7624.1 years.The mean follow-up was 13.2 months(range,0.5–117 months).The majority of patients underwent endoscopic evaluation(78%),but few patients underwent anal manometry(16%),defecography(9%)or ultrasound(3%).Ten patients(17%)underwent biofeedback/pelvic-floor physical therapy prior to repair.Nineteen patients(33%)underwent a perineal approach(most were perineal proctosigmoidectomy).Thirty-nine patients(67%)underwent repair using an abdominal approach(all were suture rectopexy)and,of these,77%were completed using a minimally invasive technique.The overall complication rate was 26%including urinary retention(16%),which was more common in patients undergoing the perineal approach(32%vs.8%,P=0.028),urinary-tract infection(7%)and wound infection(3%).The overall recurrence rate was 9%,with no difference between abdominal and perineal approaches.Information on sexual function was missing in the majority of patients both before and after surgery(76%and 78%,respectively).Conclusion:Rectal-prolapse repair in men is safe and has a low recurrence rate;however,sexual function was poorly recorded across all institutions.Further studies are needed to evaluate to best approach to and functional outcomes of rectal-prolapse repair in men.
