Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Society of Colon and Rectal Surgeons.

Treatment of Rectal Prolapse

American Society of Colon and Rectal Surgeons

Publication Date: Nov 1, 2017

Page Last Updated: May 5, 2026

The GRADE system: grading recommendations

Grade	Description	Benefit vs. risk and burdens	Quality of supporting evidence	Implications
1A	Strong recommendation, High-quality evidence	Benefits clearly outweigh risk and burdens or vice versa	RCTs without important limitations or overwhelming evidence from observational studies	Strong recommendation, can apply to most patients in most circumstances without reservation
1B	Strong recommendation, Moderate-quality evidence	Benefits clearly outweigh risk and burdens or vice versa	RCTs with important limitations (inconsistent results, methodologic flaws, indirect or imprecise) or exceptionally strong evidence from observational studies	Strong recommendation, can apply to most patients in most circumstances without reservation
1C	Strong recommendation, Low- or very-low quality evidence	Benefits clearly outweigh risk and burdens or vice versa	Observational studies or case series	Strong recommendation but may change when higherquality evidence becomes available
2A	Weak recommendation, High-quality evidence	Benefits closely balanced with risks and burdens	RCTs without important limitations or overwhelming evidence from observational studies	Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
2B	Weak recommendations, Moderate-quality evidence	Benefits closely balanced with risks and burdens	RCTs with important limitations (inconsistent results, methodologic flaws, indirect or imprecise) or exceptionally strong evidence from observational studies	Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
2C	Weak recommendation, Low- or very-low quality evidence	Uncertainty in the estimates of benefits, risks and burden; benefits, risk, and burden may be closely balanced	Observational studies or case series	Very weak recommendations; other alternatives may be equally reasonable

Document Overview

Document Title: Treatment of Rectal Prolapse

Authoring Society: American Society of Colon and Rectal Surgeons

Document Publication Date: Nov 1, 2017

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journals.lww.com/dcrjournal/Fulltext/2017/11000/Clinical_Practice_Guidelines_for_the_Treatment_of.3.aspx

Source Citation: Bordeianou, Liliana M.D., M.P.H.; Paquette, Ian M.D.; Johnson, Eric M.D.; Holubar, Stefan D. M.D.; Gaertner, Wolfgang M.D.; Feingold, Daniel L. M.D.; Steele, Scott R. M.D. Clinical Practice Guidelines for the Treatment of Rectal Prolapse, Diseases of the Colon & Rectum: November 2017 - Volume 60 - Issue 11 - p 1121-1131 doi: 10.1097/DCR.0000000000000889

Supplemental Implementation Resources

Visual Abstract

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Management, Treatment

Diseases/Conditions (MeSH)

D012005 - Rectal Prolapse

D011391 - Prolapse

D012005 - Rectal Prolapse

D011391 - Prolapse

Keywords: Rectal Prolapse, Rectopexy, colorectal

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Infant, Older Adult

Health Care Settings: Ambulatory, Emergency Care, Hospital, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 104

Literature Search Start Date: Saturday, October 1, 2011

Literature Search End Date: Thursday, December 1, 2016

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Treatment of Rectal Prolapse

Recommendations

Evaluation of Rectal Prolapse

Nonoperative Management

Operations for Rectal Prolapse

Abdominal Procedures for Rectal Prolapse

Posterior Rectal Dissection Techniques to Repair Rectal Prolapse

Posterior Suture Rectopexy With and Without Sigmoid Resection

Posterior Mesh Rectopexy

Anterior Rectal Dissection Techniques to Repair Rectal Prolapse

Ventral Rectopexy

Additional Abdominal Surgery Considerations

Perineal Operations for Rectal Prolapse

The GRADE system: grading recommendations

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology