Surgical Options for Rectal Prolapse

Rectal Prolapse refers to the protrusion of the full-thickness rectal wall through the anal canal. It is much more common in older females, but it can happen at any age and both sexes. Physiopathology is not well known, with 2 theories being favored: the hernia theory and the intussusception theory. Diagnosis is usually straightforward and relies on physical examination. Treatment is challenging due to the variety of surgical options available, with none of them being clearly superior. A choice can be made between abdominal (open, minimal invasive) or perineal approaches. Decision-making depends on the patient's general well-being, age, previous surgical interventions and symptoms. Outcomes of recurrence and function do not appear to widely differ between perineal and abdominal approaches. The management of recurrent prolapse also lacks clear evidence to guide decision-making.