Anal sphincter tears in patients with rectal prolapse and faecal incontinence

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dc.contributor.author Woods, R
dc.contributor.author Wattchow, David Anthony
dc.contributor.author Voyvodic, Frank
dc.contributor.author Sage, Michael Radford
dc.contributor.author Schloithe, Ann Carolyn
dc.date.accessioned 2010-07-27T06:08:07Z
dc.date.available 2010-07-27T06:08:07Z
dc.date.issued 2003 en_US
dc.description.abstract ObjectiveFaecal incontinence often persists after surgery for rectal prolapse. Multiple mechanisms have been proposed as responsible, however, anal sphincter integrity has only been studied in a handful of cases. This study assesses the incidence of ultrasound detected anal sphincter tears in patients with rectal prolapse and faecal incontinence.MethodsRetrospective search of medical records at Flinders Medical Centre over a 7-year period to identify patients with full thickness rectal prolapse and faecal incontinence who had undergone endosonographical imaging of the anal sphincter complex. Anal manometry and pudendal nerve terminal motor latency studies were also included.ResultsTwenty-one patients were identified (1 male, 20 female) of median age 67.5 years. Fifteen (71%) subjects had an abnormality in the anal sphincter complex on endoanal ultrasound. Of these, the defects in 4 (19%) patients were isolated to the internal sphincter, 3 (14%) to the external sphincter and in the remaining 8 (38%) subjects, defects were found in both internal and external sphincters. The degree of sphincteric defect was variable but at least 6 (29%) of the study group had full-length external sphincter tears. In the 19 patients studied, anal manometry revealed reduced basal and squeeze pressures in the majority. Delayed pudendal nerve terminal motor latency was evident in 9 of 18 patients studied.ConclusionAnal sphincter tears are common in patients presenting with rectal prolapse and faecal incontinence. The faecal incontinence associated with prolapse appears to be multifactorial in aetiology. Anal sphincter defects are likely to contribute to persistent faecal incontinence or recurrence following rectal prolapse. Endoanal ultrasound derived knowledge of anal sphincter injury may guide surgical management in problematic cases.
dc.description.note Melbourne, Australia en
dc.identifier.citation Woods, R., Voyvodic, F., Schloithe, A.C., Sage, M.R., & Wattchow, D.A., 2003. Anal sphincter tears in patients with rectal prolapse and faecal incontinence. Colorectal Disease, 5(6), 544-548. en
dc.identifier.doi https://doi.org/10.1046/j.1463-1318.2003.00469.x en
dc.identifier.issn 1462-8910 en_US
dc.identifier.rmid 2003051816 en_US
dc.identifier.uri http://hdl.handle.net/2328/10331
dc.subject.forgroup 1103 Clinical Sciences en_US
dc.title Anal sphincter tears in patients with rectal prolapse and faecal incontinence en_US
dc.type Article en_US
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