Perineal excision of rectal procidentia in elderly high-risk patients

PURPOSE: This report presents a ten-year experience with perineal excision and posterior levator ani repair in elderly, high-risk patients with complete rectal procidentia. METHODS: Seventy-two patients with rectal prolapse were treated with perineal excision. Nine presented with acute incarcerated rectal prolapse. Mortality, morbidity, recurrence rates, and improvement of anal continence were assessed. RESULTS: Recurrence rate was 5.5 percent. Improvement in anal continence was seen in 66.7 percent of patients. Morbidity and mortality was low. CONCLUSIONS: Perineal excision of rectal prolapse is safe and has a low recurrence rate. Posterior levator ani repair seems to improve anal continence.