The management of recurrent rectal prolapse

The ideal surgical procedure for full-thickness rectal prolapse should be one of minimal morbidity, effective in improving symptoms, and durable over time with a low risk of recurrence. Unfortunately, as evident from the myriad number of surgical options for prolapse, it is not surprising that recurrence continues to plague the colorectal surgeon. Recurrence rates vary widely in the literature (older reports as high as 50%), and the variation is widely perceived to reflect the different technical aspects involved with each procedure [1]. Some authors suggest, however, that surgical technique does not fully account for the variation in recurrence rates, especially among abdominal approaches [2]. Instead, differences are more likely explained by nonuniform definitions of recurrent prolapse and varying lengths of follow-up [3]. Nevertheless, it is generally accepted that recurrence following an abdominal repair (0-10%) is less common than after a perineal approach (0-25%) [4]-[7].