Bowel habit in 57
rectal prolapse patients was assessed before and after abdominal
Ivalon rectopexy. There was a significant (chi-square = 8.7, P less than 0.01) increase in prevalence of
constipation from 30 percent before to 51 percent after surgery. There were two explanations for this increased
constipation. It was mainly the result of a 28 percent increase in prevalence of
constipation among patients who were incontinent before rectopexy. Incontinent
prolapse patients were more likely to acquire a predictable bowel habit after rectopexy if they became constipated. There was also a small (7 percent) increase in prevalence of
constipation among continent patients, which could be attributed to the rectopexy procedure. In a subgroup of 15 patients, rectal wall thickness after rectopexy was assessed by pelvic computed tomographic scan carried out before and after surgery, or at more than one year after surgery. There was a significant (t = 4.5, P less than 0.001) increase in rectal wall thickness by 24 weeks after rectopexy, compared with before operation. This increase was also seen in a further five patients undergoing abdominal rectopexy without
Ivalon sponge, suggesting that it was a consequence of rectal mobilization rather than the
Ivalon sponge. This increased rectal wall thickness may impede the passage of formed stool into the lower rectum and contribute to the increased
constipation found after rectopexy.