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Techniques in Coloproctology

, Volume 22, Issue 8, pp 589–596 | Cite as

Management of patients with rectal prolapse: the 2017 Dutch guidelines

  • E. M. van der Schans
  • T. J. C. Paulides
  • N. A. Wijffels
  • E. C. J. Consten
Clinical Guidelines

Abstract

Background

Rectal prolapse—both external rectal prolapse and internal rectal prolapse—is a disabling condition. In view of the overwhelming number of surgical procedures described for the treatment of rectal prolapse, a comprehensive update concerning the diagnostic and therapeutic pathway for this condition is required to draw recommendations for clinical practice. This initiative was commissioned by the Dutch Association for Surgery (Nederlandse Vereniging voor Heelkunde) as a multidisciplinary collaboration.

Methods

Nine questions outlining the diagnostic approach, conservative and surgical management of rectal prolapse were selected. A systematic literature search for evidence was then conducted in the Medline and Embase databases.

Results

Recommendations included diagnostic approach, methods to assess complaints of fecal incontinence and/or obstructive defecation and treatment options, both conservative and surgical. A level of evidence was assigned to each statement following the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.

Conclusions

These guidelines for clinical practice are useful in the diagnosis and treatment of rectal prolapse. There are many statements requiring a higher level of evidence due to a lack of studies.

Keywords

Rectal prolapse Rectopexy Practice guideline 

Notes

Acknowledgements

The authors are grateful to the original Dutch drafting committee: S.J. van der Hagen, A. Pronk, R.J.F. Felt-Bersma, M. Stegeman, E.J.L. Bosboom, J.A.J. Kalkdijk, D.A. van Reijn and A.H.P. Meier. The authors’ gratefulness also extends to the advisory group: G.G.A. Malmberg, T. Boele, W.A. Bemelman, S. Festen, D.D.E. Zimmerman. The authors also warmly acknowledge E.A. Rake, H.L. Vreeken, W.A. van Enst.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of SurgeryMeander Medical CentreAmersfoortThe Netherlands
  2. 2.Department of SurgerySt. Antonius HospitalNieuwegeinThe Netherlands

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