{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:09:16Z","timestamp":1777489756572,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Pelvic floor retraining is considered first\u2010line treatment for patients with faecal incontinence or obstructed defaecation. There are at present no data on the effect of a high grade internal rectal prolapse on outcomes of pelvic floor retraining. The current study aimed to assess this influence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In all, 120 consecutive patients were offered pelvic floor retraining. The predominant symptom was faecal incontinence in 56 patients (47%) and obstructed defaecation in 64 patients (53%). Patients were assessed before and after therapy using the Fecal Incontinence Severity Index (<jats:styled-content style=\"fixed-case\">FISI<\/jats:styled-content>), the <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>atient <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ssessment of <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>onstipation <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ymptoms (<jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SYM<\/jats:styled-content>) score and the <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>astrointestinal <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>uality of <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>ife <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>ndex (<jats:styled-content style=\"fixed-case\">GIQLI<\/jats:styled-content>). Defaecography and anorectal manometry were performed in all patients before pelvic floor retraining.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A high grade internal rectal prolapse was observed in 42 patients (35%). In patients with faecal incontinence without a high grade internal rectal prolapse, the <jats:styled-content style=\"fixed-case\">FISI<\/jats:styled-content> score decreased from 36 to 27 (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01). The <jats:styled-content style=\"fixed-case\">FISI<\/jats:styled-content> score did not change (32 <jats:italic>vs<\/jats:italic> 32; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.93) in patients with a high grade internal rectal prolapse. The <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SYM<\/jats:styled-content> score improved significantly (24 <jats:italic>vs<\/jats:italic> 19; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.01) in patients with obstructed defaecation without a high grade rectal prolapse compared with no significant change (26 <jats:italic>vs<\/jats:italic> 25; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.21) in patients with a high grade rectal prolapse. Quality of life (<jats:styled-content style=\"fixed-case\">GIQLI<\/jats:styled-content>) improved only in patients without a high grade internal rectal prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pelvic floor retraining may be useful in patients with defaecation disorders not associated with a high grade internal rectal prolapse. Patients with a high grade internal rectal prolapse may be considered for surgery from the outset.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12367","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T07:33:44Z","timestamp":1374910424000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Does the presence of a high grade internal rectal prolapse affect the outcome of pelvic floor retraining in patients with faecal incontinence or obstructed defaecation?"],"prefix":"10.1111","volume":"15","author":[{"given":"S.","family":"Adusumilli","sequence":"first","affiliation":[{"name":"Oxford Pelvic Floor Centre Department of Colorectal Surgery Churchill Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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