BACKGROUND: When treating a @entity3577 , the most important objective is elimination of the prolapse. In addition, restoration of sufficient anorectal continence is extremely important for the @entity1 . We examined the value of posterior levator repair with respect to stabilization of the pelvic floor and to improvement in @entity322 . METHODS: In @entity1 with disabling @entity322 , a posterior levatorplasty can be concomitantly performed during operative removal of the prolapse. To facilitate evaluation of the operative results, we implemented a scoring system to judge the @entity1 ' subjective symptoms of @entity322 ; in addition, we performed manometric measurements of resting and squeezing pressures of the anal sphincter to objectify the @entity322 . RESULTS: From 1991 to 1997, 84 @entity1 (mean age 65+/-10 years, 38-91 years; 79 @entity1 , 5 @entity1 ) with @entity3577 and severe @entity322 were operatively treated; corresponding follow-ups were done. The following procedures were performed: Frykmann-Goldberg, 28 @entity1 ; Wells, 18 @entity1 ; Ripstein, 22 @entity1 ; and perineal proctectomy, 16 @entity1 . @entity322 for liquid and solid stools was present in all of these @entity1 . Posterior levatorplasty was implemented in 38 @entity1 , and in this group we found significantly better postoperative results, both clinically and in the manometric measurements. Continence was improved by 84% in the group with levatorplasty, but improvement was only 67% in the other group (P<0.05). The @entity322 score decreased significantly in the group with levatorplasty (preoperative 16.4+/-3.1, postoperative 9.3+/-4.5, P<0.05, vs the other group with preoperative 15.6+/-4.2, postoperative 11.5+/-5.1). Manometric observations in the group with levatorplasty demonstrated 55% improvement in resting pressure (preoperative 29+/-17 cm @entity2507 , postoperative 45+/-21 cm @entity2507 , P<0.05) and 40% improvement in squeezing pressure (preoperative 61+/-25 cm @entity2507 , postoperative 85+/-31 cm @entity2507 , P<0.05). In the group without levatorplasty, resting and squeezing pressure improved only by 20% (resting pressure: preoperative 32+/-16 cm @entity2507 , postoperative 38+/-18 cm @entity2507 ; squeezing pressure: preoperative 64+/-29 cm @entity2507 , postoperative 75+/-26 cm @entity2507 ). CONCLUSIONS: Posterior levatorplasty is an easy and efficient operative procedure which facilitates an improvement in anorectal continence. There are no apparent disadvantages. For this reason, levatorplasty can be part of operative procedures implemented in the treatment of a @entity3577 accompanied by disabling @entity322 .

The value of posterior levator repair in the treatment of XXXX due to rectal prolapse--a clinical and manometric study.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity2507 :: ('CHEBI:33813', 'Chemical') :: ['H2O'] @entity3577 :: ('MESH:D056887', 'Disease') :: ['complete rectal prolapse'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence', 'anorectal incontinence', 'Incontinence']
@entity322 :: (MESH:D014549,Disease) :: ['anorectal incontinence']
