Rektal prolapsus ve cerrahi tedavisi

Abstract

51 SUMMARY Retrospektif and prospective analysis evaluating 94 cases who underwent posterior rectopexy in 48 patients (51%), resection with or without rectopexy in 19 patients (20%) and Delormes's procedure in 27 patients (30%) for rectal prolapse in last 15 years was carried out. The surgical procedures were described in detail. Postoperative evaluation was possible in all patients and mean observation time was 3.2 years. Recurrence was seen in 4 cases (4.2%), only after the Delorme's procedures. Proportion of continent patients increased from 69.2% preoperatively to 91.6% postoperatively. Defecation difficulties and incomplete evacuation did not change beneficially after the posterior rectopeksy procedures. Important postoperative complications, retrograde ejaculation and impotence, were seen in 5 male patients (17.2%) after posterior rectopexy, and were a major cause of dissatisfaction. In conslusions, Delorme's procedure, posterior rectopexy and resection procedures are effective surgical operations for treatment of rectal prolapse but extensive pelvic dissection during the posterior rectopexy may create serious sexual problems in male patients.