Outcomes of Laparoscopic Posterior Rectopexy Combined with Transperineal Levatorplasty in Management of Rectal Intussusception with Descending Perineum Syndrome | ||
| Al-Azhar International Medical Journal | ||
| Volume 2025, Issue 5, May 2025, Pages 215-221 PDF (635.71 K) | ||
| Document Type: Original Article | ||
| DOI: https://doi.org/10.21608/aimj.2025.446581 | ||
| Authors | ||
| Magdy Mahmoud Mostafa1; Mohamed Hassan Al Kasser2; Ahmed Abd Alhady Ibrahim Marie* 3 | ||
| 1Professor of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 2Assistant Professor of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 3MSc, General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| Abstract | ||
| Background: One complication of fecal evacuation is rectal intussusception (RI), which goes by several names: internal intussusception, internal procidentia, occult rectal prolapse, intrarectal prolapse, and other similar terms. Aim and objectives: To detect the outcomes of laparoscopic posterior rectopexy combined with transperineal levatorplasty in the management of patients complaining of RI associated with descending perineum syndrome. Subjects and methods: This prospective study was conducted on 53 patients, who were selected from attendants to the General Surgery outpatient clinic, General Surgery department, Al-Azhar University Hospitals, from December 2022 to December 2024. Results: Significant improvements were noted in fecal incontinence and constipation. The Cleveland Clinic Incontinence Score(CCIS) showed a median preoperative score of 14.5, dropping to a median of 0 postoperatively, with 78.6% of patients showing improvement(49.1% fully continent, 28.3% with minor issues). This improvement was more pronounced in younger patients, with older age correlating with persistent incontinence(p=0.048). For constipation, the median Wexner Score decreased between 6.5-2, with 77.1% of patients experiencing amelioration(35.8% cured, 15.1% improved). Conclusion: Our study contributes important data to the evolving landscape of pelvic floor reconstructive surgery. The integration of laparoscopic posterior rectopexy with transperineal levatorplasty not only restores the anatomical position of the rectum but also reinforces the pelvic floor, leading to significant improvements in quality of life. As surgical techniques continue to evolve, the emphasis on a holistic approach addressing both structure and function will remain paramount in achieving optimal outcomes for patients suffering from complex pelvic floor disorders. | ||
| Keywords | ||
| Laparoscopic posterior rectopexy; Transperineal levatorplasty; Rectal intussusception | ||
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