Clinical Report: PRP Injections Improve Sphincter Function and QoL Post-Rectal Cancer Surgery

Overview

This prospective cohort study evaluated the effects of platelet-rich plasma (PRP) injections on anal sphincter function and quality of life in rectal cancer patients with fecal incontinence after low anterior or intersphincteric resection. Results demonstrated significant improvements in manometric parameters, Wexner incontinence scores, and patient-reported quality of life six months post-treatment.

Background

Sphincter-preserving surgery for low rectal cancer often results in fecal incontinence due to sphincter damage, affecting about half of patients. Current treatments like nerve stimulation and pelvic floor rehabilitation have limitations including transient effects and poor tolerance. PRP, rich in growth factors and cytokines, has regenerative properties and has been used in various medical fields to promote tissue healing. This study investigates PRP injections as a novel approach to improve sphincter function and quality of life in patients with post-surgical incontinence.

Data Highlights

Key Findings

• PRP injections significantly increased anal resting and maximum squeeze pressures at 6 months post-treatment.
• Patients reported a marked reduction in fecal incontinence severity, reflected by decreased Wexner scores.
• Quality of life, assessed by SF-36, improved significantly following PRP therapy.
• Pad usage and antidiarrheal medication consumption decreased after PRP treatment.
• Long-term follow-up (≥48 months) indicated sustained benefits in continence and sphincter function.

Clinical Implications

PRP injections represent a promising minimally invasive therapeutic option for patients suffering from fecal incontinence after sphincter-preserving rectal cancer surgery. By enhancing sphincter muscle function and improving quality of life, PRP may complement or provide an alternative to existing treatments, especially in patients with preserved sphincter volume and function. Careful patient selection based on manometry and ultrasound criteria is essential to optimize outcomes.

Conclusion

This study supports the efficacy of PRP injections in improving anal sphincter function and quality of life in rectal cancer patients with post-surgical fecal incontinence. PRP therapy offers a novel regenerative approach warranting further investigation in larger controlled trials.

References

1. 1,2,3 -- Sphincter preservation and fecal incontinence rates in rectal cancer surgery
2. 5,6,7 -- Limitations of current treatments for fecal incontinence
3. 8,9,10,11 -- Biological properties and regenerative potential of platelet-rich plasma
4. 12,13,14 -- Clinical applications of PRP in regenerative medicine
5. 15,16,17 -- Endoanal ultrasound criteria for sphincter volume assessment
6. 18,19,20 -- Manometric parameters related to rectal compliance and neo-rectum volume
7. 21,22 -- Validation of Wexner and SF-36 questionnaires in Turkish population