Surgical Treatment of Rectal Prolapse: A 10-Year Experience at a Single Institution

PURPOSE: Despite the plethora of surgical options, there is no consensus regarding the best treatment for rectal prolapse. This study is aimed at evaluating our experience with its treatment and outcomes.METHODS: We retrospectively reviewed rectal prolapse patients' characteristics, clinical presentation, surgical procedure, average length of hospital stay, morbidity, mortality, and recurrence over a 10 year period at our institution.RESULTS: A total of 46 patients underwent rectal prolapse repair at our institution over a 10 year period. Of the 39 patients with primary rectal prolapse, 18 patients had an abdominal procedure, while 21 patients underwent a perineal approach. Operative duration was significantly longer in abdominal procedures, of which 16 cases were performed laparoscopically. Length of hospital stay and recurrence were not statistically significant between the 2 groups. In patients with recurrent rectal prolapse, more than 80% of the initial surgeries were done using the perineal approach. An abdominal approach was utilized in the management of 75% of recurrences.CONCLUSION: An abdominal repair may be preferable in the treatment of recurrent rectal prolapse. Minimally invasive techniques may be feasible and can provide a safe alternative to perineal procedures in elderly patients.

Unusual Complication of Incarcerated Uterovaginal Prolapse: A Case Report.

Aims: The case report aims to bring out a rare and life threatening complication of incarcerated utero-vaginal prolapse. Case Report: We present a case of 55 yr old woman with incarcerated prolapse. Details of evolving clinical features and investigations that led to the suspicion of pelvic abscess are presented and discussed. Emergency intervention by colpotomy for draining the abscess was performed. Definitive surgery was performed 1 month after she fully recovered and the tissue edema and congestion subsided. Two stage management of the case is detailed. Conclusion: Spontaneous pelvic abscess is a rare but life threatening complication of incarcerated prolapse. A two stage surgery in such a situation is associated with good outcome.

A Rare Case of Prolapse Uterus.

Prolapse is the commonest complaint in elderly females. We present herein a case of procidentia with more than 200 stones in bladder of varying size, treated with vaginal hysterectomy and vesical calculi removal through bladder (abdominally).

Surgical Treatment of Rectal Prolapse

Rectal prolapse is defined as a protrusion of the rectum beyond the anus. Although rectal prolapse was recognized as early as 1500 BC, the optimal surgical procedure is still debated. The varied operative procedures available for treating rectal prolapsed can be confusing. The aim of treatment is to control the prolapse, restore continence, and prevent constipation or impaired evacuation. In elderly and high-risk patients, perineal approaches, such as Delorme's operation and Altemeier's operation, have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Abdominal operations involve dissection and fixation of the rectum and may include a rectosigmoid resection. From the late twentieth century, the laparoscopic procedure has been applied to the treatment of rectal prolapse. Current laparoscopic surgical techniques include suture rectopexy, stapled rectopexy, posterior mesh rectopexy with artificial material, and resection of the sigmoid colon with colorectal anastomosis with or without rectopexy. The choice of surgery depends on the status of the patient and the surgeon's preference.