The Ripstein procedure: a 16-year experience.

A retrospective study was undertaken, evaluating 54 patients who underwent 57 Ripstein procedures at the Cleveland Clinic Foundation during the years 1963-1978. The patients were evaluated for their preoperative characteristics as well as early and late postoperative results. Patients who experience procidentia are generally middle-aged women who have had previous gynecologic and anorectal surgery and who generally had significant disorders of bowel function. Although the operative mortality was zero, and the majority of patients were satisfied with the results of their Ripstein procedure, there was significant operative morbidity (26 per cent). Twelve and one-half per cent of patients had recurrent rectal prolapse, and 18 per cent of patients had significant long-term obstructive symptoms. The Ripstein procedure still remains the treatment of choice for rectal prolapse.