title: Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation.
abstract: OBJECTIVE
  To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.
  
  
  METHODS
  One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study. The patients with rectal prolapse hemorrhoids with outlet obstruction-induced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids (PPH) (n = 54) or conventional surgery (n = 54; control group). Short-term (operative time, postoperative hospital stay, postoperative urinary retention, postoperative perianal edema, and postoperative pain) and long-term (postoperative anal stenosis, postoperative sensory anal incontinence, postoperative recurrence, and postoperative difficulty in defecation) clinical effects were compared between the two groups. The short- and long-term efficacies of the two procedures were determined.
  
  
  RESULTS
  In terms of short-term clinical effects, operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group (24.36 ± 5.16 min vs 44.27 ± 6.57 min, 2.1 ± 1.4 d vs 3.6 ± 2.3 d, both P < 0.01). The incidence of postoperative urinary retention was higher in the PPH group than in the control group, but the difference was not statistically significant (48.15% vs 37.04%). The incidence of perianal edema was significantly lower in the PPH group (11.11% vs 42.60%, P < 0.05). The visual analogue scale scores at 24 h after surgery, first defecation, and one week after surgery were significantly lower in the PPH group (2.9 ± 0.9 vs 8.3 ± 1.1, 2.0 ± 0.5 vs 6.5 ± 0.8, and 1.7 ± 0.5 vs 5.0 ± 0.7, respectively, all P < 0.01). With regard to long-term clinical effects, the incidence of anal stenosis was lower in the PPH group than in the control group, but the difference was not significant (1.85% vs 5.56%). The incidence of sensory anal incontinence was significantly lower in the PPH group (3.70% vs 12.96%, P < 0.05). The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group, but the differences were not significant (11.11% vs 16.67% and 12.96% vs 24.07%, respectively).
  
  
  CONCLUSIONS
  PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids.
authors.affiliation: Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.affiliation: Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.affiliation: Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wen
mesh_terms: D000368:Aged; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D005260:Female; D061865:Hemorrhoidectomy / Q000009:adverse effects; D006484:Hemorrhoids / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012005:Rectal Prolapse / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
keywords: Internal rectal prolapse; Outlet obstructive constipation; Procedure for prolapse and hemorrhoids; Prospective study; Randomized controlled study