{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:01:29Z","timestamp":1793714489291,"version":"4.6.1"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,2,26]],"date-time":"2013-02-26T00:00:00Z","timestamp":1361836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgery is the only validated means of treating overt rectal prolapses, but both patients and physicians may decline or postpone the surgical approach. However, little is known on the functional outcome of nonoperated rectal prolapse. The aim of the present study was to highlight the natural history of overt rectal prolapse in patients for whom surgery was avoided or delayed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>A total of 206 patients complaining of full\u2010thickness rectal prolapse were referred to a single institution that provided anorectal physiology for functional anorectal disorders. Standardized questionnaires, anorectal manometry, endosonography, and evacuation proctography constituted a prospective database. Fecal incontinence was evaluated with the Cleveland Clinic score (CCIS), and constipation was evaluated with the Knowles Eccersley Scott Symptom score (KESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two nonoperated patients (mean age: 61 \u00b1 16 years) were compared to those of operated patients paired according to age and gender: the mean follow\u2010up was 44 \u00b1 26\u00a0months. The two groups had a similar past\u2010history, follow\u2010up, stool frequency, and main complaints, but lower quantified symptomatic scores and a better quality of life were reported in the nonsurgical group. At the end of follow\u2010up, the nonsurgical group did not show any variation in CCI and KESS scores. By contrast, these two scores significantly improved in the rectopexy group. Sixteen nonoperated patients experienced a degradation of their continence status with an average increase of 5 \u00b1 4.3 points of the CCIS. The patients with a CCIS &lt;7 at referral were likely to deteriorate as compared to those having a higher score. Patients with a symptom history longer than 4 years never improved and in two\u2010thirds continence deteriorated throughout the follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the absence of the surgical option, patients with a 4\u2010year duration of rectal prolapse and those with mild incontinence had no chance of improvement. These findings may be taken into account when surgery of rectal prolapse is not chosen.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-1967-z","type":"journal-article","created":{"date-parts":[[2013,2,25]],"date-time":"2013-02-25T16:09:24Z","timestamp":1361808564000},"page":"1297-1302","source":"Crossref","is-referenced-by-count":21,"title":["No Surgery for Full\u2010Thickness Rectal Prolapse: What Happens with Continence?"],"prefix":"10.1002","volume":"37","author":[{"given":"Diane","family":"Cunin","sequence":"first","affiliation":[{"name":"CHU Rennes Service de Chirurgie H\u00e9patobiliaire et Digestive 35033 Rennes France"},{"name":"Universit\u00e9 Rennes 1 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Siproudhis","sequence":"additional","affiliation":[{"name":"CHU Rennes Service des Maladies de l\u2019Appareil Digestif 35033 Rennes France"},{"name":"Universit\u00e9 Rennes 1 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Desfourneaux","sequence":"additional","affiliation":[{"name":"CHU Rennes Service de Chirurgie H\u00e9patobiliaire et Digestive 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Berkelmans","sequence":"additional","affiliation":[{"name":"CHU Rennes Service des Maladies de l\u2019Appareil Digestif 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Meunier","sequence":"additional","affiliation":[{"name":"CHU Rennes Service de Chirurgie H\u00e9patobiliaire et Digestive 35033 Rennes France"},{"name":"Universit\u00e9 Rennes 1 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Bretagne","sequence":"additional","affiliation":[{"name":"CHU Rennes Service des Maladies de l\u2019Appareil Digestif 35033 Rennes France"},{"name":"Universit\u00e9 Rennes 1 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Bouguen","sequence":"additional","affiliation":[{"name":"CHU Rennes Service des Maladies de l\u2019Appareil Digestif 35033 Rennes France"},{"name":"Universit\u00e9 Rennes 1 35033 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncpgasthep0952"},{"key":"e_1_2_6_3_2","first-page":"CD001758","article-title":"Surgery for complete rectal prolapse in adults","volume":"4","author":"Tou S","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463\u20101318.2011.02612.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010001\u20100389\u20109"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236639"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0399\u20108320(06)73076\u20107"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010008\u20100489\u2010x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00341295"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.12.1737"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.167.2.8686626"},{"key":"e_1_2_6_13_2","first-page":"299","article-title":"Anal incontinence in adults. 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