A prospective, randomized study comparing abdominal rectopexy and sigmoid resection (Group I; n = 15) with
polyglycolic acid mesh rectopexy without sigmoidectomy (Group II; n = 15) for complete
rectal prolapse was carried out. One patient in Group I died of
myocardial infarction, one patient in Group II had a small bowel obstruction and two patients in Group I an asymptomatic
stricture of the anastomosis. Otherwise a safe and efficient control of the
prolapse was achieved in both groups. Eleven (73%) patients in Group I and 12 (80%) patients in Group II were more or less incontinent before surgery. After correction of
prolapse incontinence improved in eight and ten patients in Groups I and II, but became slightly worse in one patient in Group II. A similar rise in anal pressures was measured in both groups after surgery.
Constipation disappeared in three and seven patients in Groups I and II six months after surgery, but five additional patients in Group II became severely constipated and
colectomy had to be performed in one of them. Surgery caused no significant change in colonic transit times even though increased transit times were measured in each group six months postoperatively. Sigmoid resection in conjunction with rectopexy does not seem to increase operative morbidity but tends to diminish postoperative
constipation possibly by causing less outlet obstruction.