Management guidelines for full-thickness rectal prolapse

Abstract

Given the profusion of surgical approaches in rectal prolapse, despite their history, there is currently no agreed-upon management strategy for this condition [1]. This situation, coupled with the unknown demographics of isolated full-thickness rectal prolapse or that combined with genital prolapse [2, 3], has been one of the stimulants for the ongoing PROSPER (PROlapse Surgery: PErineal or Rectopexy) trial being conducted in the UK. The trial, designed to recruit and randomise 1,000 patients, commenced in 2004 and separated short-term perioperative results and functional outcomes by comparing two main abdominal operations, abdominal rectopexy and resection rectopexy, with two principal perineal procedures, the Delorme mucosectomy and the Altemeier perineal rectosigmoidectomy. The prospective collection of this data will create the largest available randomised trial for surgical treatment of rectal prolapse in the adult. It will assess basic demography, risk factors, standardised defecatory function and quality of life. © 2008 Springer-Verlag Italia.