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International Journal of Colorectal Disease

, Volume 24, Issue 2, pp 201–207 | Cite as

Prolapse of the rectum, long-term results of surgical treatment

  • Anders T. Hoel
  • Arne Skarstein
  • Kjell K. OvreboEmail author
Original Article

Abstract

Aims

This study evaluates patency and functional results of abdominal and perineal treatment approaches to prolapse of the rectum.

Methods

A database search identified patients operated upon for prolapse of the rectum. The operations were abdominal or perineal approaches. The patient’s records were reviewed, patients alive were contacted, and a self-report form evaluated functional results. Patients were followed until the prolapse recurred.

Results

A primary operation for prolapse of the rectum was performed in 56 patients. Median age was 59 years (range 20–87) and 78 (40–91) for abdominal and perineal approaches, respectively (p < 0.001). The average length of the prolapses was 8.7 cm (2–25) and 8.6 cm (2–15) for abdominal or perineal approaches. All prolapses treated with a Thiersch’s operation recurred within a few months and all prolapses treated with the Delorme’s operation recurred within 5 years, whereas the 5-year patency of the abdominal approach was 93% (p < 0.001). No prolapses recurred after mesh rectopexy and the 5-year patency of resection rectopexy was 86%. The abdominal approaches improved stool evacuation and constipation significantly, and anal leakage improved somewhat (p = 0.065). The median hospital stay was 11 (4–20) and 7 (2–155) days after abdominal and perineal approaches (p = 0.003). Complications occurred in 20% of patients.

Conclusions

The patency of abdominal approach to prolapse of the rectum is better than that of perineal repairs. The abdominal approaches also have a favorable effect on constipation and anal insufficiency. Perineal approaches should be reserved for patients with a very short life expectancy.

Keywords

Rectal prolapse Surgery Constipation Fecal incontinence Rectum 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Anders T. Hoel
    • 1
  • Arne Skarstein
    • 1
    • 2
  • Kjell K. Ovrebo
    • 1
    Email author
  1. 1.Department of SurgeryHaukeland University HospitalBergenNorway
  2. 2.Department of Surgical SciencesHaukeland University HospitalBergenNorway

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