title: Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes.
abstract: BACKGROUND
  Solitary rectal ulcer syndrome (SRUS) is a rare disorder often misdiagnosed as a malignant ulcer. Histopathological features of SRUS are characteristic and pathognomonic; nevertheless, the endoscopic and clinical presentations may be confusing. The aim of the present study was to assess the clinical findings, surgical treatment, and outcomes in patients who suffer from SRUS.
  
  
  METHODS
  A retrospective chart review was undertaken, from January 1989 to May 2005 for all patients who were diagnosed with SRUS. Data recorded included: patient's age, gender, clinical presentation, past surgical history, diagnostic and preoperative workup, operative procedure, complications, and outcomes.
  
  
  RESULTS
  During the study period, 23 patients were diagnosed with SRUS. Seven patients received only medical treatment, and in three patients, the ulcer healed after medical treatment. Sixteen patients underwent surgical treatment. In four patients, the symptoms persisted after surgery. Two patients presented with postoperative rectal bleeding requiring surgical intervention. Three patients developed late postoperative sexual dysfunction. One patient continued suffering from rectal pain after a colostomy was constructed. Median follow-up was 14 (range 2-84) months.
  
  
  CONCLUSIONS
  The results of this study show clearly that every patient with SRUS must be assessed individually. Initial treatment should include conservative measures. In patients with refractory symptoms, surgical treatment should be considered. Results of anterior resection and protocolectomy are satisfactory for solitary rectal ulcer.
authors: Department of Colorectal Surgery, Cleveland Clinic Florida, 2950, Cleveland clinic Blvd., Weston, FL 33332, USA.
authors: Carlos
authors: C
authors: Torres
authors: Marat
authors: M
authors: Khaikin
authors: Jorge
authors: J
authors: Bracho
authors: Cheng Hua
authors: CH
authors: Luo
authors: Eric G
authors: EG
authors: Weiss
authors: Dana R
authors: DR
authors: Sands
authors: Susan
authors: S
authors: Cera
authors: Juan J
authors: JJ
authors: Nogueras
authors: Steven D
authors: SD
authors: Wexner
mesh_terms: D000328:Adult; D000368:Aged; D019841:Defecography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014456:Ulcer / Q000601:surgery*
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