Recurrent Rectal Prolapse: Re-recurrence Rate and Risk Factors

Abstract Background: Surgical intervention for rectal prolapse (RP) is frequently associated with high recurrence rates, which often necessitate subsequent reoperations. Currently, there are no established guidelines to support surgical decision-making in cases of recurrent RP (RRP) surgery. Objectives: To evaluate the re-recurrence rate of RP and identify risk factors independently associated with re-recurrence. Design: A single-center, retrospective cohort study. Setting: A high-volume tertiary referral centers, spanning the years 2010 to 2023. Patient and Methods: Inclusion criteria: Patients who underwent RRP surgery to treat the first recurrence. Exclusion criteria: Patients who underwent RRP surgery to treat a second recurrence or subsequent recurrences. Univariate and multivariate analyses were performed to identify independent re-recurrence risk factors. Main Outcomes Measures: The re-recurrence rate and risk factors independently associated with re-recurrence. Sample Size: A total of 129 patients were included, with a mean follow-up of 17.6 (27.1) months. Results: The mean age of the cohort was 68.1 (15.5) years, with 123 (95.3%) patients being women. RRP was managed via a perineal approach in 48 (37%) patients and an abdominal approach in 81 (63%) patients. The overall re-recurrence rate was 26.4% (34 patients). Multivariate analysis revealed that the perineal approach to RRP surgery was the sole risk factor independently associated with re-recurrence (odds ratio 2.97, confidence interval 1.09, 8.58, P = .037). Conclusions: In our study, the perineal approach to RRP surgery was identified as the only independent risk factor associated with re-recurrence. We recommend that surgeons consider utilizing the abdominal approach to treat RRP to minimize the risk of re-recurrence. Limitations: The retrospective nature of the study. Conflicts of Interest: No conflicts of interest.