A retrospective cohort study on clinical presentation and surgical management of rectal prolapse at a tertiary care center

Introduction: Rectal prolapse, a condition with a high prevalence in elderly women, requires surgical intervention for definitive management. The choice between abdominal and perineal surgical approaches is critical, as it balances patient fitness, recurrence risk, and functional outcomes. This study compares the perioperative and functional results of these two principal strategies in a contemporary surgical cohort. Methods: A retrospective analysis was conducted on 57 patients undergoing prolapse surgery from January 2020 to December 2023. Data on demographics, surgical details, and outcomes (complications, recurrence, functional improvement) were analyzed. Results: The mean age was 60.69 years, with 71.93% female patients. Abdominal approaches (68.42%) had longer operative times (126.88 vs. 83.64 minutes, P < 0.001) and hospital stays (8.83 vs. 6.36 days, P = 0.015) than perineal approaches. The recurrence rate was 8.77%. Complication profiles differed: ileus was more common after abdominal surgery, while wound issues occurred only after perineal surgery. Functional improvement was noted in 76.92% of incontinent patients and 68.75% of constipated patients. Conclusion: Both surgical approaches are effective, with distinct recovery and complication profiles. The choice should be individualized, with abdominal techniques offering durable repair and functional benefits for suitable patients, aligning with the trend toward minimally invasive surgery.