Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram

Abstract

Abstract Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine wire electromyography of the internal anal sphincter (IAS), external anal sphincter and puborectalis, together with anorectal manometry, using a computerized system. Examinations were performed both before and 3 to 4 months after rectopexy. The median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG) frequency was 0.18 (0.05–0.31) Hz and the median (i.q.r.) preoperative resting anal pressure was 28 (15–64) cmH2O. An improvement in the IAS EMG frequency, median (i.q.r.) 0.29 (0.19–0.38) Hz (P < 0.03), and resting anal pressure, median (i.q.r.) 41 (20–72) cmH2O (P < 0.05), was recorded after operation, but these variables remained significantly lower than those found in normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36–0.48) Hz and median (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent rectoanal inhibition.