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Strategy for Selection of Type of Operation for Rectal Prolapse Based on Clinical Criteria

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Diseases of the Colon & Rectum

PURPOSE: Reports of outcome after surgery for rectal prolapse predominantly relate to single operative procedures. A single surgical operation is not appropriate for all patients with rectal prolapse. We describe a selective policy based on clinical criteria. METHODS: Patients were offered surgery according to the following broad clinical protocol. Those who were unfit for abdominal surgery had a perineal operation. The remainder had a suture abdominal rectopexy. A sigmoid resection was added for patients in whom incontinence was not a predominant symptom. RESULTS: Surgery was performed in 159 patients. Of these, 57 had a perineal operation, 65 had fixation rectopexy, and 37 had resection rectopexy. There were no in-hospital deaths, and major complications occurred in five patients (3.5 percent). Minimum follow-up was 3 years. Of the 143 patients with long-term follow-up, recurrence occurred in 7 (5 percent). Constipation increased from 41 to 43 percent (59–61/143) and incontinence decreased from 43 to 19 percent (61 to 27/143). CONCLUSIONS: A selective policy has improved outcome compared with reports of a single operation. Future studies might consider an objective method of selecting the type of operation for rectal prolapse.

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Authors and Affiliations

  1. Department of Coloproctology, Glasgow Royal Infirmary, Glasgow, United Kingdom

    A. J. Brown M.B., Ch.B., J. H. Anderson M.D., R. F. McKee M.D. & I. G. Finlay M.B., Ch.B.

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  1. A. J. Brown M.B., Ch.B.
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  2. J. H. Anderson M.D.
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  3. R. F. McKee M.D.
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  4. I. G. Finlay M.B., Ch.B.
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Correspondence to A. J. Brown M.B., Ch.B..

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Brown, A., Anderson, J., McKee, R. et al. Strategy for Selection of Type of Operation for Rectal Prolapse Based on Clinical Criteria. Dis Colon Rect 47, 103–107 (2004). https://doi.org/10.1007/s10350-003-0013-x

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