Surgical management for rectal prolapse: an update.

Surgical management of rectal prolapse remains a challenge with the bredth of choices available and varies on the international, national, regional and locoregional level depending on expertise, comfort and perception of the available evidence. Long-standing opinions on approach of repair, abdominal vs. perineal, have been based on limited evidence and on anesethetic methods that are now relics of the past. Laparoscopic surgical repair and modern anesthethesia has made the abdominal approach more attractive even to the octagenerian with multiple comorbidities. Surgical management should still be individualized and prior to offering surgical correction of rectal prolapse one must understand each patient's syptoms, particularly incontinence and constipation, as well the effect rectal prolapse has on the patient's overall quality of life.