Combined Treatment of Modified Perineal Procedure and Ventral Rectopexy in Male Patients with External Rectal Prolapse

Laparoscopic ventral rectopexy (LVR) has become the preferred treatment for patients with external rectal prolapse (ERP). However, its efficacy in male patients has raised concerns due to a higher recurrence rate. We evaluated the outcome of modifications to the LVR technique in men with ERP. Four male patients who underwent a combination of perineal and LVR procedures for ERP were included. The perineal procedure involved cauterization of the mucosa on the posterior surface of the prolapsed rectum using a saline-cooled radiofrequency coagulation device. Subsequently, longitudinal sutures were applied to plicate the rectal muscular wall along with the cauterized mucosa, ensuring the apposition of intact mucosa. The median follow-up duration was 24 months (range: 19 − 26 months), during which no postoperative complications were observed. Clinical examinations and postoperative defecography revealed no cases of recurrent ERP. The combined perineal and LVR treatment approach for ERP in male patients appears to effectively prevent recurrence for up to 2 years.