Ripstein procedure. Lahey Clinic experience: 1963-1985.

We reviewed our 22-year experience with 135 Ripstein procedures for rectal prolapse in 118 women and 17 men. Follow-up ranged from one to 256 months (median, 41 months). Five patients were unavailable for follow-up. There was one perioperative death (0.7%). Complications included hemorrhage from presacral veins in 11 patients (8.1%), recurrent prolapse in 13 patients (9.6%), and stricture at the site of the sling in three patients (2.2%). Specific intraoperative technical factors could be related to recurrent prolapse in four patients (30.8%). Attention to technical details is mandatory to minimize immediate and long-term complications. Patients should be prepared for anterior resection, since a sling procedure may be inadvisable at the time of exploration. Resection may be the preferred operation for men, who have a high rate of recurrent prolapse with the Ripstein procedure.