Rectal distensibility and symptoms after stapled and Milligan-Morgan operation for hemorrhoids.
BACKGROUND
In a previous uncontrolled study, a reduction of rectal distensibility and volume thresholds for sensations have been related to the occurrence of fecal urgency and/or increased stool frequency after stapled hemorrhoidopexy.


OBJECTIVE
The aim of this study was to compare rectal symptoms and sensory-motor function after stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.


METHODS
The clinical records of 12 (four women) and ten patients (four women) with third- and fourth-degree hemorrhoids, respectively, who underwent stapled hemorrhoidopexy or Milligan-Morgan's hemorrhoidectomy, were evaluated. One week before and 6 months after surgery, rectal motor and sensory response to distension was assessed by an electronic barostat, and bowel and rectal symptoms were recorded by means of a 7-day diary and Bristol Index scale and psychological symptoms with SCL-90 questionnaire.


RESULTS
Rectal distensibility and volume thresholds for sensations were significantly lower after surgery (P < 0.02) in the stapled group. Increased stool frequency and/or fecal urgency arose in 41% of patients in the stapled group and associated with altered rectal distensibility. No difference within and between groups could be demonstrated in SCL-90 score.


CONCLUSIONS
Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.
Corsetti
Maura
M
Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy. corsetti.maura@hsr.it
De Nardi
Paola
P
Di Pietro
Salvatore
S
Passaretti
Sandro
S
Testoni
Pier Alberto
PA
Staudacher
Carlo
C
D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006484:Hemorrhoids / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000294:innervation / Q000503:physiopathology*; D012677:Sensation / Q000502:physiology; D011795:Surveys and Questionnaires; D013537:Sutures