Anterior and posterior rectopexy with levator repair in patients with rectal prolapse and incontinence

A prospective clinical, manometric and radiological study has been performed, before and after rectopexy, on 18 female patients with complete rectal prolapse, and varying degrees of incontinence. All patients, mean age 62 years, underwent anterior-posterior fixation (Ivalon or Vicryl) of the rectum with posterior pelvic repair of the puborectalis muscle. 13 patients with obstipation and rectal prolapse were treated by rectopexy combined with sigmoidectomy. Postoperatively there was a significant increase in the resting anal pressure and maximum voluntary contraction pressure (p = 0.01). Continence was improved in 16 patients (89 percent), 9 (56 percent) of whom regained normal continence. No significant change in pelvic descent or anorectal angle was seen postoperatively. Following abdominal rectopexy and resection obstipation was reduced in 9 of 13 patients (70 percent).