Management of recurrent rectal prolapse

Aim: Evaluation of results of the redo operations performed for recurrent rectal prolapse.

Material and methods: This study entered 16 patients after redo surgery for recurrent rectal prolapse between 1998 and 2010. There were 14 female and 2 male patients aged from

42 to 92 (mean age 69 years). Primary abdominal rectopexy was performed in 5 patients, 3 patients underwent perineal rectosigmoidectomy, 1 patient had abdominal sigmoidectomy, Delorme procedure was applied in 2 patients, Thiersch encirclement in 4 patients and perineoplasty in 1 patient. There were redo operations for recurrent prolapse as follows: abdominal rectopexy in 7 patients, perineocolporectopexy in 3 females, rectopexy with sigmoidectomy in 2 patients, Altemeier operation in 7 patients and Longo procedure in 1 patient.

Results: Permanent correction of prolapse was successful in 12 (75%) patients. Following relapses were recognized in 3 patients who underwent Altemeier operation and in 1 patient after the Longo procedure. There were no statistically significant differences regarding faecal incontinence and obstructed defecation between the patients before and after the operation.

Conclusions: Abdominal rectopexy is the method of choice for the treatment of recurrent rectal prolapse. Rectopexy combined with correction of associated anatomical defects of the pelvic floor results in a better functional outcome. Redo operations with the perineal approach are burdened with a high rate of recurrence.