ABSTRACT

Background:

Rectal prolapse presents with a constellation of symptoms which can impact on patient lifestyle. Significant equipoise exists amongst the surgical community with regards to the diagnosis of internal rectal prolapse and its management.

Objective:

To demonstrate that the management of patients with rectal prolapse is far from standardized and that there is uncertainty in the decision making in rectal prolapse treatment.

Methods:

A prospective survey to assess practices was mailed to colorectal surgeons in Australia and New Zealand. The survey was divided into sections on surgeon demographics, patient evaluation, clinical scenarios with varied patient morbidity and preferred surgical approach, and finally a section on complications and follow-up.

Results:

The results of this study illustrate that as in other countries, the management of patients with rectal prolapse is far from standardized. Most controversy appears to be associated with the significance of the different grades of internal rectal prolapse verses external rectal prolapse and then its subsequent management. It was also noted that treatment preferences varied when comparing senior with junior colorectal surgeons.

Conclusion:

This survey affirmed that the management of patients with rectal prolapse is far from standardized and that there is uncertainty in the decision making in rectal prolapse treatment. By shedding more light on the debate amongst surgeons, this survey demonstrates the need for further more prospective studies to be conducted to aide in the development of guidelines.