Surgical treatment of rectal prolapse. A retrospective analysis of 94 cases.

METHODS

A retrospective analysis evaluating 94 patients who underwent posterior rectopexy in 48 patients (51%), resection with or without rectopexy in 19 patients (20%) and Delorme's procedure in 27 patients (29%) was carried out for rectal prolapse in the last 15 years. The surgical procedures are described in detail. Postoperative evaluation was possible in all patients and mean observation time was 3.2 years.

RESULTS

Mortality rate was zero. Recurrence was seen in 4 cases (4.2%), only after Delorme's procedures. The proportion of continent patients increased from 69.2% preoperatively to 91.6% postoperatively. Defecation difficulties and incomplete evacuation did not change beneficially after the surgery. Important postoperative complications, retrograde ejaculation and impotence were seen in 5 male patients (17.2) after posterior rectopexy, and were a major cause of dissatisfaction.

CONCLUSIONS

In conclusion, Delorme's procedure, posterior rectopexy and resection procedures are effective surgical operations for treatment of rectal prolapse but extensive pelvic dissection during the posterior rectopexy may create serious sexual problems in male patients.