Repair of rectal prolapse using a puborectal sling procedure

Many procedures have been described for the repair of rectal prolapse. Some are associated with a high recurrence rate and do not correct associated fecal incontinence. During the last four years, we have operated on 15 patients using a puborectal sling fashioned of polypropylene mesh. Nine were women and six were men, with ages ranging from 25 to 72 years. Eight patients had fecal incontinence. During a follow-up of six months to four years, rectal prolapse did not recur. Fecal incontinence was totally resolved in all cases. The morbidity and death rates were both 0%, and no long-term problems have been associated with use of the synthetic material. This procedure is a sound alternative for patients with complete rectal procidentia and fecal incontinence, as it corrects the associated anatomic defect of the anorectal angle.