Poor symptomatic relief and quality of life in patients treated for "solitary rectal ulcer syndrome without external rectal prolapse".
BACKGROUND
Solitary rectal ulcer syndrome (SRUS) is a chronic disabling condition. Several therapeutic options have been advocated including conservative approaches and surgery, bringing into question their functional outcomes. This study aimed to assess treatment procedures on both anorectal complaints and quality of life (QoL) using standardised self-administered questionnaires.


METHODS
Forty-one patients who underwent treatments for SRUS in two referral centres were reviewed. A standardised self-administered questionnaire including incontinence (Cleveland Clinic), constipation (Knowles-Eccersley-Scott symptom, KESS) and gastrointestinal quality of life index validated scoring systems was mailed to each patient (median follow-up, 36 months). Correlation between treatment options, functional results and quality of life was analysed.


RESULTS
The mean Cleveland Clinic and KESS scores were respectively 5.3+/-5.8 (normal 0) and 19.1+/-8 (normal<9). The mean QoL score reached 89+/-28.8 (normal 125). A linear correlation between the QoL score and functional results was observed. There was no influence of treatment options on QoL results. A multivariate analysis identified five parameters predictive of a better QoL: presence of paradoxical puborectalis contraction, absence of descending perineum, absence of procidentia, age<40 and treatment exclusively based on laxatives.


CONCLUSIONS
Despite several therapeutic options including surgery, patients with SRUS still frequently complain of disturbed anorectal function and significant alteration of their QoL.
Meurette
G
G
Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (CCDE-IMAD), Nantes University Hospital, Hotel-Dieu, Nantes, France. Guillaume.meurette@wanadoo.fr
Siproudhis
L
L
Regenet
N
N
Frampas
E
E
Proux
M
M
Lehur
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D003248:Constipation / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D013505:Digestive System Surgical Procedures; D004599:Electric Stimulation Therapy; D005242:Fecal Incontinence / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005602:France; D041981:Gastrointestinal Tract / Q000503:physiopathology; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011788:Quality of Life; D012002:Rectal Diseases / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012005:Rectal Prolapse / Q000503:physiopathology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*
D054368:Laxatives