Rectal Prolapse in the Aged

Abstract

The purpose of this report is to evaluate the clinical characteristics and the result of operative therapy in rectal prolapse of the over 60 elderly patients.
Of the 61 patients 35 were incomplete rectal prolapse and 26 were the complete one. Male to female ratio was 18 to 17 in the incomplete type, and 4 (male) to 22 (female) in complete type.
The longest duration of complaint was 30 years period in the incomplete type with hemorrhoids, 7 years in the one without hemorrhoids and 19 years in the complete type.
Main symptoms were sensation of prolapse, anal bleeding and pain. Anal pain was observed with high incidence in the incomplete type with hemorrhoids, and with low in both the incomplete type without hemorrhoids and the complete type.
There were no correlation between the rectal prolapse and the associated diseases, which might cause high abdominal pressure, such as prostatic hypertrophy, chronic bro-nchitis and constipation.
On the surgical techniques, a simple procedure should be chosen to the older or debilitated patients. We prefer the ligature and excision method to incomplete prolapse and the variation of Sudeck's method, in which the rectum was freed from the front of the sacrum and elevated by fixing the sigmoid colon posteriorly with elevation of pelvic floor by peritoneal plasty, to complete prolapse.
There were 4 cases of relapse after the 44 operations.