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Management of Recurrent Rectal Prolapse: Surgical Approach Influences Outcome

  • Published:
Diseases of the Colon & Rectum

Introduction

Recurrent rectal prolapse is an unresolved problem and the optimal treatment is debated. This study was designed to review patterns of care and outcomes in a large cohort of patients after surgery for recurrent prolapse.

Methods

From 685 patients who underwent operative repair for full-thickness external rectal prolapse, we identified 78 patients (70 females; mean age, 66.9 years) who underwent surgery for recurrence. We reviewed the subsequent management and outcomes for these 78 patients.

Results

Mean interval to their first recurrence was 33 (range, 1–168) months. There were significantly more re-recurrences after reoperation using a perineal procedure (19/51) compared with an abdominal procedure (4/27) for their recurrent rectal prolapse (P = 0.03) at a mean follow-up of nine (range, 1–82) months. Patients undergoing abdominal repair of recurrence were significantly younger than those who underwent perineal repair (mean age, 58.5 vs. 71.5 years; P < 0.01); however, there was nosignificant difference between the two groups with regard to the American Society of Anesthesiologists classification (P = 0.89). Eighteen patients had surgery for a second recurrence, with perineal repairs associated with higher failure rates (50 vs. 8 percent; P = 0.07). Finally, when combining all repairs, the abdominal approach continued to have significantly lower recurrence rates (39 vs. 13 percent; P < 0.01).

Conclusions

The re-recurrence rate after surgery for recurrent rectal prolapse is high, even at a relatively short follow-up interval. Our data suggest that abdominal repair of recurrent rectal prolapse should be undertaken if the patient's risk profile permits this approach.

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Authors and Affiliations

  1. Department of Colorectal Surgery, University of Minnesota, Minneapolis, Minnesota, USA

    Scott R. Steele M.D., Laura H. Goetz M.D., Shigeki Minami M.D., Robert D. Madoff M.D., Anders F. Mellgren M.D. & Susan C. Parker M.D.

  2. 9606 Piperhill Drive SE, Olympia, Washington, 98513, USA

    Scott R. Steele M.D.

Authors
  1. Scott R. Steele M.D.
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  2. Laura H. Goetz M.D.
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  3. Shigeki Minami M.D.
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  4. Robert D. Madoff M.D.
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  5. Anders F. Mellgren M.D.
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  6. Susan C. Parker M.D.
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Corresponding author

Correspondence to Scott R. Steele M.D..

Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, Philadelphia, Pennsylvania, April 30 to May 5, 2005.

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Steele, S.R., Goetz, L.H., Minami, S. et al. Management of Recurrent Rectal Prolapse: Surgical Approach Influences Outcome. Dis Colon Rectum 49, 440–445 (2006). https://doi.org/10.1007/s10350-005-0315-2

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  • DOI: https://doi.org/10.1007/s10350-005-0315-2

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