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Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): management and treatment of complete rectal prolapse


Rectal prolapse, rectal procidentia, “complete” prolapse or “third-degree” prolapse is the full-thickness prolapse of the rectal wall through the anal canal and has a significant impact on quality of life. The incidence of rectal prolapse has been estimated to be approximately 2.5 per 100,000 inhabitants with a clear predominance among elderly women. The aim of this consensus statement was to provide evidence-based data to allow an individualized and appropriate management and treatment of complete rectal prolapse. The strategy used to search for evidence was based on application of electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL and EMBASE. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by the American College of Gastroenterology’s Chronic Constipation Task Force. Five evidence levels were defined. The recommendations were graded A, B, and C.

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  1. 1.

    Lowry AC, Simmang CL, Boulos P et al (2001) Consensus statement of definitions for anorectal physiology and rectal cancer, Washington DC May 1, 1999. Dis Colon Rectum 44:915–919

  2. 2.

    Kairaluoma MV, Kellokumpu IH (2005) Epidemiologic aspects of complete rectal prolapse. Scand J Surg 94:207–210

  3. 3.

    Rentea RM, St Peter SD (2018) Pediatric rectal prolapse. Clin Colon Rectal Surg 31:108–116

  4. 4.

    Michalopoulos A, Papadopoulos VN, Panidis S et al (2011) Surgical management of rectal prolapse. Tech Coloproctol 15(Suppl 1):S25–S28

  5. 5.

    Wilson J, Engledow A, Crosbie J, Arulampalam T, Mot-son R (2011) Laparoscopic non resectional suture rectopexy in the management of full-thickness rectal prolapse: substantive ret-rospective series. Surg Endosc 25:1062–1064

  6. 6.

    Corman ML (ed) (2004) Rectal prolapse, solitary rectal ulcer, syndrome of the descending perineum, and rectocele. In: Colon and rectal surgery, 5th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1408

  7. 7.

    Goldstein SD, Maxwell PJ 4th (2011) Rectal prolapse. Clin Colon Rectal Surg 24:39–45

  8. 8.

    Moschvowitz AV (1912) The pathogenesis, anatomy and cure of prolapseof the rectum. Surg Gynecol Obstet 15:7

  9. 9.

    Devadhar DSC (1965) A new concept of mechanism and treatment of rectal procidentia. Dis Colon Rectum 8:75–78

  10. 10.

    Madiba TE, Baig MK, Wexner SD (2005) Surgical management of rectal prolapse. Arch Surg 140:63–73

  11. 11.

    Madden MV, Kamm MA, Nicholls RJ, Santhanam AN, Cabot R, Speakman CT (1992) Abdominal rectopexy for complete prolapse: prospective study evaluating changes in symptoms and anorectal function. Dis Colon Rectum 35:48–55

  12. 12.

    Blumberg D, Wald A (2002) Other diseases of the colon and rectum. In: Feldman M, Friedman LS, Sleisenger MH (ed) Sleisenger and Fordtran’s gastrointestinal and liver disease. 7th edn. WB Saunders, Philadelphia, pp. 2294–2295

  13. 13.

    Tjandra JJ, Fazio VW, Church JM, Milsom JM, Oakley JR, Lavery IC (1993) Ripstein procedure is an effective treatment for rectal prolapse without constipation. Dis Colon Rectum 36:501–507

  14. 14.

    American College of Gastroenterology Chronic Constipation Task Force (2005) An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S1–S4

  15. 15.

    Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE (2014) Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. J Gastrointest Surg 18:1059–1069

  16. 16.

    Zbar AP, Nguyen H (2008) Management guidelines for full-thickess rectal prolapse. In: Altomare DF, Pucciani F (eds) Rectal prolapse. Diagnosis and clinical management. Springer, Milan, pp 201–206

  17. 17.

    Cunin D, Siproudhis L, Desfourneaux V et al (2013) No surgery for full-thickness rectal prolapse: what happens with continence? World J Surg 37:1297–1302

  18. 18.

    Varma M, Rafferty J, Buie WD (2011) Practice parameters for the management of rectal prolapse. Dis Colon Rectum 54:1339–1346

  19. 19.

    Tou S, Brown SR, Nelson RL (2015) Surgery for complete (full-thickness) rectal prolapse in adults. Cochrane Database Syst Rev 11:CD001758

  20. 20.

    Evans C, Ong E, Jones OM, Cunningham C, Lindsey I (2014) Laparoscopic ventral rectopexy is effective for solitary rectal ulcer syndrome when associated with rectal prolapse. Colorectal Dis 16:O112–O116

  21. 21.

    Kang YS, Kamm MA, Engel AF, Talbot IC (1996) Pathology of the rectal wall in solitary rectal ulcer syndrome and complete rectal prolapse. Gut 38:587–590

  22. 22.

    Rao SS, Ozturk R, De Ocampo S, Stessman M (2006) Pathophysiology and role of biofeedback therapy in solitary rectal ulcer syndrome. Am J Gastroenterol 101:613–618

  23. 23.

    Gonzalez-Argente FX, Jain A, Nogueras JJ, Davila GW, Weiss EG, Wexner SD (2001) Prevalence and severity of urinary incontinence and pelvic genital prolapse in females with anal incontinence or rectal prolapse. Dis Colon Rectum 44:920–926

  24. 24.

    Baden WF, Walker T (1972) Genesis of the vaginal profile: a correlated classification of vaginal relaxation. Clin Obstet Gynecol 15:1048–1054

  25. 25.

    Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

  26. 26.

    Abrams P, Andersson KE, Birden L et al (2009) Recommendation of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. In Abrams P, Cardozo L, Koury S, Wein A (eds), Incontinence: 4th international consultation on incontinence, 4 edn. Health Publications Ltd, Paris

  27. 27.

    Araki I, Haneda Y, Mikami Y, Takeda M (2009) Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation. Int Urogynecol J 20:1301–1306

  28. 28.

    Hill J, Corson RJ, Brandon H, Redford J, Faragher EB, Kiff ES (1994) History and examination in the assessment of patients with idiopathic fecal incontinence. Dis Colon Rectum 37:473–477

  29. 29.

    Dvorkin LS, Chan CL, Knowles CH, Williams NS, Lunniss PJ, Scott SM (2004) Anal sphincter morphology in patients with full-thickness rectal prolapse. Dis Colon Rectum 47:198–203

  30. 30.

    Woods R, Voyvodic F, Schloithe AC, Sage MR, Wattchow DA (2003) Anal sphincter tears in patients with rectal prolapse and faecal incontinence. Colorectal Dis 5:544–548

  31. 31.

    Osman MM, Abd El Maksoud WM, Gaweesh YS (2015) Delorme’s operation plus sphincteroplasty for complete rectal prolapse associated with traumatic fecal incontinence. J Biomed Res 29:326–331

  32. 32.

    Chun SW, Pikarsky AJ, You SY et al (2004) Perineal rectosigmoidectomy for rectal prolapse: role of levatorplasty. Tech Coloproctol 8:3–8

  33. 33.

    Pannu HK, Kaufman HS, Cundiff GW, Genadry R, Bluemke DA, Fishman EK (2000) Dynamic MR imaging of pelvic organ prolapse: spectrum of abnormalities. Radiographics 20:1567–1582

  34. 34.

    Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 54:454–457

  35. 35.

    Piloni VL, Bazzocchi A, Golfieri R (2008) Functional imaging in rectal prolapse. In: Altomare DF, Pucciani F (eds) Rectal prolapse. Diagnosis and clinical management. Springer, Milan, pp 21–32

  36. 36.

    Rao SS, Siddiqui J (2007) Diagnosis of fecal incontinence. In: Ratto C, Doglietto GB (eds) Fecal incontinence. Diagnosis and treatment. Springer, Milan, pp 95–105

  37. 37.

    Pucciani F (2017) Anorectal manometry. In: Ratto C, Parello A, Donisi L, Litta F (eds) Colon, rectum and anus: anatomic, physiologic and diagnostic bases for disease management. Springer, Cham, pp 277–283

  38. 38.

    Glasgow SC, Birnbaum EH, Kodner IJ, Fleshman JW, Dietz DW (2006) Preoperative anal manometry predicts continence after perineal proctectomy for rectal prolapse. Dis Colon Rectum 49:1052–1058

  39. 39.

    Leroi AM (2017) Electrophysiological study of the pelvic floor. In: Ratto C, Parello A, Donisi L, Litta F (eds) Colon, rectum and anus: anatomic, physiologic and diagnostic bases for disease management. Springer, Cham, pp 286–301

  40. 40.

    Nash DF (1972) Bowel management in spina bifida patients. Proc R Soc Med 65:70–71

  41. 41.

    Siafakas C, Vottler TP (1999) Rectal prolapse in pediatrics. Clin Pediatr 38:63–72

  42. 42.

    Cares K, El-Baba M (2016) Rectal Prolapse in children: significance and management. Curr Gastroenterol Rep 18:22

  43. 43.

    Birnbaum EH, Stamm L, Rafferty JF, Fry RD, Kodner IJ, Fleshman JW (1996) Pudendal nerve terminal motor latency influences surgical outcome in treatment of rectal prolapse. Dis Colon Rectum 39:215–1221

  44. 44.

    Schultz I, Mellgren A, Nilsson BY, Dolk A, Holmström B (1998) Preoperative electrophysiologic assessment cannot predict continence after rectopexy. Dis Colon Rectum 41:1392–1398

  45. 45.

    Myers JO, Rothenberger DA (1991) Sugar in the reduction of incarcerated prolapsed bowel: report of two cases. Dis Colon Rectum 34:416 – 418

  46. 46.

    Livovsky DM, Adler SN, Adar T, Bar-Gil Shitrit A, Lysy J (2015) Tricyclic antidepressants for the treatment of tenesmus associated with rectal prolapse. Colorectal Dis 17(12):1094–1099

  47. 47.

    Pucciani F, Iozzi L, Masi A, Cianchi F, Cortesini C (2003) Multimodal rehabilitation for faecal incontinence: experience of an Italian centre devoted to faecal disorder rehabilitation. Tech Coloproctol 7:139–147

  48. 48.

    Pescatori M, Zbar AP (2009) Tailored surgery for internal and external rectal prolapse: functional results of 268 patients operated upon by a single surgeon over a 21-year period*. Colorectal Dis 11(4):410–419. https://doi.org/10.1111/j.1463-1318.2008.01626.x

  49. 49.

    Pinheiro LV, Leal RF, Coy CS, Fagundes JJ, Martinez CA, Ayrizono ML (2016) Long-term outcome of perineal rectosigmoidectomy for rectal prolapse. Int J Surg 32:78–82. https://doi.org/10.1016/j.ijsu.2016.06.040

  50. 50.

    Ris F, Colin JF, Chilcott M, Remue C, Jamart J, Kartheuser A (2012) Altemeier’s procedure for rectal prolapse: analysis of long-term outcome in 60 patients. Colorectal Dis 14(9):1106–1111. https://doi.org/10.1111/j.1463-1318.2011.02904.x

  51. 51.

    Altomare DF, Binda G, Ganio E et al (2009) Long-term outcome of Altemeier’s procedure for rectal prolapse. Dis Colon Rectum 52(4):698–703. https://doi.org/10.1007/DCR.0b013e31819ecffe

  52. 52.

    Riansuwan W, Hull TL, Bast J, Hammel JP, Church JM (2010) Comparison of perineal operations with abdominal operations for full-thickness rectal prolapse. World J Surg 34(5):1116–1122. https://doi.org/10.1007/s00268-010-0429-0

  53. 53.

    Bordeianou L, Paquette I, Johnson E et al (2017) Clinical practice guidelines for the treatment of rectal prolapse. Dis Colon Rectum 60:1121–1131. https://doi.org/10.1097/DCR.0000000000000889

  54. 54.

    Mustain WC, Davenport DL, Parcells JP, Vargas HD, Hourigan JS (2013) Abdominal versus perineal approach for treatment of rectal prolapse: comparable safety in a propensity-matched cohort. Am Surg 79(7):686–692

  55. 55.

    Senapati A, Gray RG, Middleton LJ, Harding J, Hills RK, Armitage NC, Buckley L, Northover JM (2013) PROSPER: a randomised comparison of surgical treatments for rectal prolapse. Colorectal Dis 15(7):858–868. https://doi.org/10.1111/codi.12177

  56. 56.

    Emile SH, Elbanna H, Youssef M et al (2017) Laparoscopic ventral mesh rectopexy vs Delorme’s operation in management of complete rectal prolapse: a prospective randomized study. Colorectal Dis 19(1):50–57. https://doi.org/10.1111/codi.13399

  57. 57.

    Tiengtianthum R, Jensen CC, Goldberg SM, Mellgren A (2014) Clinical outcomes of perineal proctectomy among patients of advanced age. Dis Colon Rectum 57(11):1298–1303. https://doi.org/10.1097/DCR.0000000000000225%5D

  58. 58.

    Wijffels N, Cunningham C, Dixon A, Greenslade G, Lindsey I (2011) Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete? Colorectal Dis 13:561–566

  59. 59.

    Lieberth M, Kondylis LA, Reilly JC, Kondylis PD (2009) The Delorme repair for full-thickness rectal prolapse: a retrospective review. Am J Surg 197(3):418–423

  60. 60.

    Garely AD, Krieger BR, Ky AJ (2014) Rectal prolapse. In: Cameron JL, Cameron AM (eds) Current surgical therapy. Elsevier Saunders, Philadelphia, pp 190–194

  61. 61.

    Ding JH, Canedo J, Lee SH, Kalaskar SN, Rosen L, Wexner SD (2012) Perineal rectosigmoidectomy for primary and recurrent rectal prolapse: are the results comparable the second time? Dis Colon Rectum 55(6):666–670

  62. 62.

    Steele SR, Goetz LH, Minami S, Madoff RD, Mellgren AF, Parker SC (2006) Management of recurrent rectal prolapse: surgical approach influences outcome. Dis Colon Rectum 49(4):440–445

  63. 63.

    Cirocco WC (2014) Explaining the undulating outcomes of perineal rectosigmoidectomy (Altemeier procedure) for rectal prolapse over the last century: technique matters! Tech Coloproctol 18:979–980

  64. 64.

    Balakrishna NS, Sushrutha CS, Sathish O et al (2017) Comparison between laparoscopic suture rectopexy and Altemeier’s procedure for the management of complete rectal prolapse—a single center retrospective observational study. J Evid Based Med Healthc 4(44):2685–2690

  65. 65.

    Yoshioka K, Ogunbiyi OA, Keighley MR (1998) Pouch perineal rectosigmoidectomy gives better functional results than conventional rectosigmoidectomy in elderly patients with rectal prolapse. Br J Surg 85(11):1525–1526

  66. 66.

    Baig MK, Galliano D, Larach JA, Weiss EG, Wexner SD, Nogueras JJ (2005) Pouch perineal rectosigmoidectomy: a case report. Surg Innov 2(4):373–375

  67. 67.

    Zbar AP, Takashima S, Hasegawa T et al (2002) Perineal rectosigmoidectomy (Altemeier’s procedure): a review of physiology, technique and outcome. Tech Coloproctol 6:109–116

  68. 68.

    Cernuda RB, Ángel JP, Fernández NT, Sánchez-Farpón JH, Pérez JA (2016) Perineal rectosigmoidectomy (Altemeier procedure) as treatment of strangulated rectal prolapse. J Gastrointest Surg 20(12):2102–2103

  69. 69.

    Voulimeneas I, Antonopoulos C, Alifierakis E, Ioannides P (2010) Perineal rectosigmoidectomy for gangrenous rectal prolapse. World J Gastroenterol 7(21):2689–2691 16(

  70. 70.

    Raahave D, Jensen AK, Dammegaard L, Pedersen IK (2016) Primary and repeated perineal stapled prolapse resection. Tech Coloproctol 20:853–857. https://doi.org/10.1007/s10151-016-1557-9

  71. 71.

    Ram E, Krissi H, Zbar A, Atar E, Joubran S, Rath-Wolfson L (2014) Perineal stapled prolapse resection (PSPR) in elderly patients for external rectal prolapse: early experience. Tech Coloproctol 18:1003–1007

  72. 72.

    Sehmer D, Marti L, Wolff K, Hetzer FH (2013) Midterm results after perineal stapled prolapse resection for external rectal prolapse. Dis Colon Rectum 56:91–96

  73. 73.

    Tschuor C, Limani P, Nocito A, Dindo D, Clavien PA, Hahnloser D (2013) Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term? Tech Coloproctol 17:537–540

  74. 74.

    Mistrangelo M, Tonello P, Brachet Contul R et al (2016) Perineal stapled prolapse resection for full-thickness external rectal prolapse: a multicentre prospective study. Colorectal Dis 18:1094–1100

  75. 75.

    Förster CE, Füglistaler I, Steinemann DC (2018) Intraoperative check for enterocele in perineal stapled prolapse resection. Tech Coloproctol 22:389–391. https://doi.org/10.1007/s10151-018-1796-z

  76. 76.

    Elagili F, Gurland B, Liu X, Church J, Ozuner G (2015) Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier. Tech Coloproctol 19(9):521–525

  77. 77.

    Fleming FJ, Kim MJ, Gunzler D, Messing S, Monson JR, Speranza JR (2012) It’s the procedure not the patient: the operative approach is independently associated with an increased risk of complications after rectal prolapse repair. Colorectal Dis 14(3):362–368

  78. 78.

    Tsunoda A, Yasuda N, Yokoyama N, Kamiyama G, Kusano M (2003) Delorme’s procedure for rectal prolapse: clinical and physiological analysis. Dis Colon Rectum 46:1260–1265

  79. 79.

    Goldman J (1988) Concerning prolapse of the rectum with special emphasis on the operation by Thiersch. Dis Colon Rectum 31:154–155

  80. 80.

    Madsen MA (2008) Perineal approaches to rectal prolapse. Clin Colon Rectal Surg 21(2):100–105

  81. 81.

    Eftaiha SM, Calata JF, Sugrue JJ et al (2017) Bio-thiersch as an adjunct to perineal proctectomy reduces rates of recurrent rectal prolapse. Dis Colon Rectum 60(2):187–193

  82. 82.

    Yamana T, Iwadare J (2003) Mucosal plication (Gant-Miwa procedure) with anal encircling for rectal prolapse—a review of the Japanese experience. Dis Colon Rectum 46:S94–S99

  83. 83.

    Qaradaghy SHS, Hawram TAH, Nore BF et al (2014) Longitudinal plication—a surgical strategy for complete rectal prolapse management. BMC Surg 14:17

  84. 84.

    Karas JR, Uranues S, Altomare DF et al (2011) No rectopexy versus rectopexy following rectal mobilisation for full-thickness rectal prolapse: a randomised controlled trial. Dis Colon Rectum 54(1):29–34

  85. 85.

    Nelson R, Spitz J, Pearl RK, Abcarian H (2001) What role does full rectal mobilization play in the treatment of rectal prolapse? Tech Coloproctol 5(1):33–35

  86. 86.

    Raftopoulos Y, Senagore AJ, Di Giuro G, Bergamaschi R (2005) Recurrence rates after abdominal surgery for complete rectal prolapse: a multicenter pooled analysis of 643 individual patient data. Dis Colon Rectum 48:1200–1206

  87. 87.

    Aitola PT, Hiltunen KM, Matikainen MJ (1999) Functional results of operative treatment of rectal prolapse over an 11-year period: emphasis on transabdominal approach. Dis Colon Rectum 42:655–660

  88. 88.

    Luukkonen P, Mikkonen U, Järvinen H (1992) Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis 7:219–222

  89. 89.

    Sayfan J, Pinho M, Alexander-Williams J, Keighley MR (1990) Sutured posterior abdominal rectopexy with sigmoidectomy compared with Marlex rectopexy for rectal prolapse. Br J Surg 77:143–145

  90. 90.

    McKee RF, Lauder JC, Poon FW, Aitchison MA, Finlay IG (1992) A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse. Surg Gynecol Obstet 174:145–148

  91. 91.

    Varma JS (1992) Autonomic influences on colorectal motility and pelvic surgery. World J Surg 16(5):811–819

  92. 92.

    El Muhtaseb MS, Bartolo DC, Zayiae D, Salem T (2014) Colonic transit before and after resection rectopexy for full-thickness rectal prolapse. Tech Coloproctol 18(3):273–276

  93. 93.

    Speakman CTM, Madden MV, Nicholls RJ, Kamm MA (1991) Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomized study. Br J Surg 78(12):1431–1433

  94. 94.

    Mollen RM, Kuijpers JH, Van Hoek F (2000) Effect of rectal mobilisation and lateral sphincter division on colonic and anorectal function. Dis Colon Rectum 43(9):1283–1287

  95. 95.

    Cutait D (1959) Sacro-promontory fixation of the rectum for complete rectal prolapse. Proc R Soc Med 52(suppl):105

  96. 96.

    Hrabe J, Gurland B (2016) Optimizing treatment for rectal prolapse. Clin Colon Rectal Surg 29(3):271–276

  97. 97.

    Novell JR, Osborne MJ, Winslet MC, Lewis AA (1994) Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full-thickness rectal prolapse. Br J Surg 81(6):904–906

  98. 98.

    Samaranayake CB, Luo C, Plank AW, Merrie AE, Plank LD, Bissett IP (2010) Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 12:504–512

  99. 99.

    Boons P, Collinson R, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis 12:526–532

  100. 100.

    Winde G, Reers B, Nottberg H, Berns T, Meyer J, Bunte H (1993) Clinical and functional results of abdominal rectopexy with absorbable mesh-graft for treatment of complete rectal prolapse. Eur J Surg 59(5):301–305

  101. 101.

    Galili Y, Rabau M (1997) Comparison of polyglycolic acid and polypropylene mesh for rectopexy in the treatment of rectal prolapse. Eur J Surg 163(6):445–448

  102. 102.

    Calişkan C, Denizli A, Makay O et al (2009) Experimental comparison of meshes for rectal prolapse surgery. Eur Surg Res 43(3):310–314

  103. 103.

    Smart NJ, Pathak S, Boorman P, Daniels IR (2013) Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy—a systematic review. Colorectal Dis 15(6):650–654

  104. 104.

    Balla A (2017) Synthetic versus biological mesh-related erosion after laparoscopic ventral mesh rectopexy: a systematic review. Ann Coloproctol 33:46–51

  105. 105.

    Berman IR (1992) Suturless laparoscopic rectopexy for procidentia. Technique and implications. Dis Colon Rectum 35:689–693

  106. 106.

    Formijne HA (2013) Evaluation and surgical treatment of rectal prolapse proplapse: an international survey. Colorectal Dis 15:115–119

  107. 107.

    Kariv Y (2006) Long-term outcome after laparoscopic and open surgery for rectal prolapse: a case-control study. Surg Endosc 20:35–42

  108. 108.

    Solomon MJ (2002) Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg 89:35–39

  109. 109.

    Tou S (2008) Surgery for complete rectal prolapse in adults. Cochrane Database Sys Rev 4:123–135

  110. 110.

    Sajid MS (2010) Open versus laparoscopic repair of full-thickness rectal prolapse: a re-meta-analysis. Colorectal Dis 12:515–525

  111. 111.

    Cadeddu F (2012) Focus on abdominal rectopexy for full-thickness rectal prolapse: meta-analysis of literature. Tech Coloproctol 16:37–53

  112. 112.

    Sahoo MR (2014) A single centre comparative study of laparoscopic mesh rectopexy versus suture rectopexy. J Minim Access Surg 10:18–22

  113. 113.

    Mackenzie H (2014) Proficiency gain curve and predictors of outcome for laparoscopic ventral mesh rectopexy. Surgery 156:158–167

  114. 114.

    Gultekin FA (2015) Safety of laparoscopic ventral rectopexy in the elderly: results from a nationwide database. Dis Colon Rectum 58:339–343

  115. 115.

    Pierrenot C (2013) Long-term outcomes of robot-assisted laparoscopic rectopexy for rectal prolapse. Dis Colon Rectum 56:909–914

  116. 116.

    Rondelli F (2014) Robot-assisted or conventional laparoscopic rectopexy for rectal prolapse. Systematic review and meta-analysis. Int J Surg 12:S153–S159

  117. 117.

    Iersel JJ (2017) Robot-assistedventral mesh rectopexy for rectal prolapse: A 5 year experience at a tertiary referral center. Dis Colon Rectum 60:1215–1223

  118. 118.

    Makela-Kaikkonen J (2016) Robot-assisted vs laparoscopic ventral rectopexy for external or internal prolapse and enterocele: a randomized controlled trial. Colorectal Dis 18:1010–1015

  119. 119.

    Tomohide H, Daiki Y, Takafumi M et al (2018) Surgical options for full-thickness rectal prolapse: current status and institutional choice. Ann Gastroenterol 31:188–197

  120. 120.

    Ricciardi R, Roberts PL, Read TE, Hall JF et al (2014) Which operative repair is associated with a higher likelihood of reoperation after rectal prolapse repair? Am Surg 80(11):1128–1131

  121. 121.

    Russell MM, Read TE, Roberts PL et al (2012) Complications after rectal prolapse surgery: does approach matter? Dis Colon Rectum 55(4):450–458

  122. 122.

    Fang SH, Cromwell JW, Wilkins KB et al (2012) Is the abdominal repair of rectal prolapse safer than perineal repair in the highest risk patients? An NSQIP analysis. Dis Colon Rectum 55(11):1167–1172

  123. 123.

    Catanzarite T, Klaristenfeld DD, Tomassi MJ, Zazueta-Damian G, Alperin M (2018) Recurrence of rectal prolapse after surgical repair in women with pelvic organ prolapse. Dis Colon Rectum. https://doi.org/10.1097/DCR.0000000000001023

  124. 124.

    Jonkers HAF, Draaisma WA, Wexner SD et al (2013) Evaluation and surgical treatment of rectal prolapse: an international survey. Colorectal Dis 15:115–119

  125. 125.

    Gunner CK, Senapati A, Northover JM, Brown SR (2016) Life after PROSPER. What do people do for external rectal prolapse? Colorectal Dis 18(8):811–814

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Gallo, G., Martellucci, J., Pellino, G. et al. Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): management and treatment of complete rectal prolapse. Tech Coloproctol 22, 919–931 (2018). https://doi.org/10.1007/s10151-018-1908-9

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  • External rectal prolapse
  • Rectal procidentia
  • Non-operative management
  • Surgical treatment
  • Abdominal approach
  • Perineal approach