The management of procidentia. 30 years' experience

This is a retrospective study evaluating 179 patients with complete rectal prolapse operated on at the University of Minnesota affiliated hospitals from 1953 to 1983 with no mortality. One hundred and two of 138 patients who underwent abdominal proctopexy and sigmoid resection were followed from six months to 30 years with a recurrence rate of 1.9 percent. Twenty-two of the 33 patients who underwent perineal rectosigmoidectomy were followed from six months to three years with no recurrence. Nine patients who underwent abdominal proctopexy and subtotal colectomy because of colonic inertia associated with procidentia were followed from one to six years with no recurrence. Patient interviews revealed that 72 to 80 percent considered their results as excellent or good. Incontinence or persistent constipation caused the remaining patients to consider their results fair or poor, despite anatomic correction of the prolapse. Abdominal proctopexy and sigmoid resection was more likely to result in improvement of continence than was perineal rectosigmoidectomy.