Restorative proctocolectomy for idiopathic megarectum: Postoperative recovery of hypotonic anal sphincters

PURPOSE: Restorative proctocolectomy has been advocated in the treatment of idiopathic megacolon, provided there is normal sphincter function. We report two patients undergoing this procedure, despite abnormal sphincter function. METHODS: Anorectal manometry and detailed symptom review were performed both preoperatively and at various stages postoperatively in two young patients with idiopathic megarectum. RESULTS: Both patients had progressive sphincter recovery postoperatively, shown both manometrically and with symptomatic review. CONCLUSION: Low preoperative sphincter pressures in young patients with idiopathic megarectum may not preclude successful outcome after restorative proctocolectomy.