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Related Experiment Videos

Management of recurrent rectal prolapse

S A Fengler1, R K Pearl, M L Prasad

  • 1F. Edward Herbert School of Medicine, Uniformed Services University of the Health Sciences, Brooke Army Medical Center, Ft. Sam Houston, Texas 78234-6200, USA.

Diseases of the Colon and Rectum
|July 1, 1997
PubMed
Summary

Reoperative surgery for recurrent rectal prolapse can successfully manage prolapse but may not restore fecal continence. Surgeons should consider non-resectional procedures for failed initial repairs.

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Area of Science:

  • Colorectal Surgery
  • Surgical Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Rectal prolapse management often involves surgery, yet recurrence rates exceed 15%.
  • Limited literature addresses reoperative strategies for failed rectal prolapse repairs.
  • This study focuses on managing recurrent rectal prolapse after initial surgical interventions.

Purpose of the Study:

  • To summarize experience with recurrent rectal prolapse.
  • To provide suggestions for reoperative management of failed rectal prolapse repairs.
  • To evaluate outcomes of both abdominal and perineal approaches for recurrent rectal prolapse.

Main Methods:

  • A retrospective review of 14 patients (mean age 68) who underwent surgery for recurrent rectal prolapse.

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  • Analysis of initial operations (perineal proctectomy, anal encirclement, Delorme's, anterior resection) and subsequent reoperative procedures.
  • Average follow-up of 50 months to assess outcomes of reoperations.

    • Main Results:

    • No further episodes of complete rectal prolapse were observed post-reoperation.
    • Reoperative procedures did not restore fecal continence in three previously incontinent patients.
    • One patient died postoperatively from an unrelated cause after anal encirclement.

    Conclusions:

    • Surgical management of recurrent rectal prolapse can resolve prolapse but not always incontinence.
    • Perineal proctectomies are safely repeatable for recurrent rectal prolapse.
    • Non-resectional procedures like Delorme's are recommended for recurrent rectal prolapse if the initial repair was resectional.