The mean time to tolerating a diet was 2.3 days (100% within 4 d) and mean postoperative length of hospital stay was 4.2 days (93% within 6 d). The present study has a number of limitations. Federal government websites often end in .gov or .mil. How to do an Altemeier perineal rectosigmoidectomy for full - PubMed Recurrence of the prolapse was analyzed. The aim of this retrospective study was to evaluate morbidity, mortality, postoperative function and recurrences in patients treated by Altemeiers rectosigmoidectomy for complete rectal prolapse in a referral center for pelvic floor functional disorders. Potential Risks Bleeding or hematoma development requiring reoperation. There was no statistically significant difference in the Vaizey score before and after surgery (p=1.000) (Fig. Marzouk D, Ramdass MJ, Haji A, et al. Auguste T, Dubreuil A, Bost R, et al. Thirty four patients were assessed at a median interval of 49 (2135) months, six being deceased for reason not related to the prolapse and three lost to follow-up. 3 0 obj Color Dis. Cookies policy. Experience and results]. There are two parts to the first step of this procedure. Female gender with possible obstetric trauma, the wider pelvis and weaker pelvic floor due to age and gender are factors that would contribute to poor function and the failure of repair of the prolapse to alter most of the functional scores indicates that the prolapse itself may not be an important factor in the bowel and urinary dysfunction often observed in patients with prolapse. The mean pre and post-operative scores for the various functional indices are shown in Table 1. If procedures are performed using the open approach with percutaneous endoscopic assistance or hand-assisted laparoscopy they are coded as open. Secure .gov websites use HTTPSA Your doctor is likely to recommend drinking lots of fluids, using stool softeners, and eating a fiber-rich diet in the weeks after surgery to avoid constipation and excessive straining that can lead to recurrence of the rectal prolapse. Reviewing how a NFLs Team medical injuries can Impact the whole series, CBD vs. THC: 7 Things Every Beginner Should Know. The procedure consists of a perianal rectosigmoidectomy, followed by a coloanal anastomosis, which is hand-sewn or stapled, and associated with a levatorplasty. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Altemeiers procedure is one of the well-known perineal operations to treat full-thickness rectal prolapse; it removes the prolapse without a pexy and performs only a partial reconstruction of the pouch of Douglas. Unauthorized use of these marks is strictly prohibited. The Altemeiers procedure is an available low risk treatment that can be performed under regional anesthesia, recovery is rapid and it gives immediate relief of the prolapse itself. 2011;13:5616. Recurrence over time(Kaplan-Meier curve). The ASA score was I [6 patients], II [21], III [15] and IV [1]. 2005;27(5):4149. Modified perineal linear stapler resection for external rectal prolapse. Rectal-prolapse repair in men is safe, but outcomes are not well understood. eCollection 2020 Jun. Altemeiers procedure for rectal prolapse: analysis of long-term outcome in 60 patients. The .gov means its official. Gastroenterol Clin Biol. PDF Surgery Codes Rectum - Surveillance, Epidemiology, And End Results Abdominal repair require general anesthesia and may contribute to the possible formation of pelvic adhesions, posing a potential risk of infertility in young female and of impotence in males with the addition of the risk of anastomotic leakage if a resection rectopexy is performed even if resection is nowadays seldom performed [19]. lock Altemeier Procedure for Full-thickness Rectal Prolapse Complicated by Ischemic Stricture - YouTube This edited video shows the performance of an Altemeier Procedure for a patient with. How Monitoring Your HRV Can Help You Keep Track of Your Overall Health with Welltory, 8 Common Practices That Actually Cause Damage To Your Oral Health, Travel Nursing Skills: 6 Skills & Qualities, No, I Dont Want To Receive Healthcare Breaking News Reports. It is indicated in symptomatic patients with an external . Bordeianou L, Paquette I, Johnson E, et al. https:// Surgical site and urinary tract infection were considered to be minor. [Surgical treatment of rectal prolapse with transanal resection according to Altemeier. Clinical practice guidelines for the treatment of rectal prolapse. Altomare DF, Di Lena M, Giuratrabocchetta S, et al. The colon carries waste to be expelled from the body. of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy, Department of Biostatistics, S.Gaudenzio Clinic, Policlinico di Monza, Italy, Department of General Surgery, University of Catanzaro, Catanzaro, Italy, You can also search for this author in A p-value of <0.05 was considered to be statistically significant. %PDF-1.5 Fecal incontinence improved in 11 patients, worsened in 10 and was unchanged in 13. Your surgeon will suggest the appropriate one for you based on your condition and your overall health. 2020 ICD-10-PCS | CMS - Centers For Medicare & Medicaid Services During the more commonly performed form of this procedure (Altemeier procedure), the surgeon pulls the rectum through the anus, removes a portion of the rectum and sigmoid and attaches the remaining rectum to the large intestine (colon). The mean preoperative scores for constipation and incontinence, the ICIQ SF score and preoperative residual urinary volume score are given in Table1. California Privacy Statement, Surgical treatments for rectal prolapse: how does a perineal approach compare in the laparoscopic era? Comparison of the preoperative and postoperative obstructed defecation syndrome (ODS) scores. Methods: Bookshelf Senapati A, Gray RG, Middleton LJ, et al. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. 2019 Nov;23(11):1065-1072. doi: 10.1007/s10151-019-02100-z. Despite anatomical correction by surgery, patients frequently complain persisting pelvic floor symptoms and recurrences. So, it could be an available option for frail patients with complete rectal prolapse. Would you like email updates of new search results? ICD-10-PCS Code Lookup, ICD 10 Procedure Codes - AAPC Correspondence to 1 0 obj The procedure is most effective when treating elderly, frail patients and postoperative morbidity rates are low. 2012 Sep;14(9):1106-11. doi: 10.1111/j.1463-1318.2011.02904.x. No.:CD001758. External rectal prolapse: abdominal or perineal repair for men? Dis Colon Rectum. Disclaimer. Comparison between pre-operative and post-operative functional scores was performed using the paired t-test or Wilcoxons rank sum test for paired data. There was a statistically significant decrease postoperatively in the median of the differences of 2.5 (p<0.001) (Fig. Recurrences in our series occurred in 35% of cases, with an estimated risk of at 48months of 40% (Table4) [10,11,12,13,14,15,16,17,18, 24,25,26,27,28,29,30]. Data on follow-up and recurrences. Curr Probl Surg. Treatment of rectal prolapse. Ris F, Colin JF, Chilcott M, et al. Some people require physical therapy to relearn how to use the pelvic floor muscles. Perineal rectosigmoidectomy (Altemeier's procedure), as used for the surgical treatment of full-thickness rectal prolapse, has a long history. Cirocco WC. 206.598.5668. Boccasanta P, Venturi M, Barbieri S, Roviaro G. Dis Colon Rectum. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS) Kimmins MH, Evetts BK, Isler J, et al. ICD-10-PCS has a 7 character alpha-numeric code structure that provides a unique code for all substantially different procedures, and allows new procedures to be incorporated as new codes. Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcome A. P. Zbar, S. Takashima, T. Hasegawa & K. Kitabayashi Techniques in Coloproctology 6 , 109-116 ( 2002) Cite this article 1043 Accesses 53 Citations Metrics Abstract. Advertising revenue supports our not-for-profit mission. Surgical Procedures on the Digestive System. The ICD-10-PCS is a procedure classification published by the United States for Laparoscopic anterior rectopexy to the promontory for full-thickness rectal prolapse in 175 consecutive patients short- and long-term follow-up. 2015;(11). Percutaneous approach is entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and/or any other body layers necessary to reach the site of the procedure. Nat Clin Pract Gastroenterol Hepatol. You'll spend a brief time in the hospital recovering and regaining your bowel function. This site complies with the HONcode standard for trustworthy health information: verify here. Peri-operative data on 43 consecutive female patients were reviewed. The coding options listed within this guide are commonly used codes and are not intended to be an all-inclusive list. Tech Coloproctol. Information on Altemeier's operation Enquiries: 07500870587 or 01519295181 enquiries@wirralsurgeon.co.uk www.wirralsurgeon.co.uk The Altemeier's Operation Altemeier's operation (perineal rectosigmoidectomy) is a surgical procedure used to correct a full-thickness rectal prolapse. evaluated the perioperative outcome of patients with complete rectal prolapse from the American College of Surgeon National Surgical Quality Improvement Program (NSQIP) to determine the safety of different surgical approaches. By using this website, you agree to our In our series although a statistically significant reduction in the ODS score was found, there was no change in any of the other parameters used to assess bowel and urinary function. Clipboard, Search History, and several other advanced features are temporarily unavailable. For the past 30 years, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. Roberta Tutino. How to do an Altemeier perineal rectosigmoidectomy for full-thickness rectal prolapse Authors Shinichiro Sakata 1 , Nicholas P McKenna 1 , Ahmed Allawi 1 , Anne-Lise D D'Angelo 1 , Heidi K Chua 1 , Eric J Dozois 1 Affiliation 1 Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA. CPT Code 45130 - Excision Procedures on the Rectum - AAPC Ann Surg. The procedure is known as the Altemeier perineal rectosigmoidectomy. Step 1 - The Anal Retractor Insertion and Rectal Wall Incision There are two parts to the first step of this procedure. [Surgical options in the treatment of rectal prolapse: indications, techniques and results]. All procedures currently performed can be specified in ICD-10-PCS. 2023 ICD-10-PCS Procedure Code 0DTP0ZZ Resection of Rectum, Open Approach 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code ICD-10-PCS 0DTP0ZZ is a specific/billable code that can be used to indicate a procedure. Privacy uLj/nHFtGi=OijL9N2Jwh[27gXA{8H@j.aHMdJ,348aJ^Lhx=8Yet49/HD6*D>n@Z{{K5#H&5TqrB8H.GhXCvFq((X 7 2004;38(3):43844. 2001;44(4):56570. The relationship between changes in the ODS score and Vaizey score in respect to levatorplasty was evaluated using the unpaired t-test and the Mann-Whitney U-test. These 2020 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020. Tech Coloproctol. As for recurrence, the most logical treatment is a second Altemeier procedure. Altemeier | definition of Altemeier by Medical dictionary National Library of Medicine Every year, in the OPPS rule, Medicare publishes a list of CPT1 and HCPCS codes that are designated as device-intensive procedures. The 45505 code is for a proctoplasty for prolapse of mucous membrane. Rectal prolapse repair through the area around the anus (perineal rectosigmoidectomy). A small nick in the skin or small incision made in the skin does not constitute an open approach. Accessibility Carditello A, Milone A, Stilo F, Mollo F, Basile M. Zentralbl Chir. When applying the sutures, there is a requirement for a full-thickness stitch that runs from the submucosa to the inside and then the return stitch from the inside to the outside. Grade 4 occurred in 44-years old patient with an history of dementia, Parkinson, chronic bronchitis and recurrent ab aspiration pneumonias who presented with an aspiration pneumonia and lung failure. Would you like email updates of new search results? Reissman P, Weiss E, Teoh TA, Cohen SM, Wexner SD. Pre and post-operative functional scores and data above recurrences and time to recurrences collected from each patient. There was no post-operative mortality at 30days. National Library of Medicine These interesting results are actually changing the attitude toward a use of this minimal invasive abdominal technique in the management of full thickness rectal prolapse for all patients. This site needs JavaScript to work properly. During this period there were twelve cases (35%) of recurrence which resulted in a risk of recurrence at 48months of approximately 40% (Fig. This content does not have an English version. The relatively high number of recurrences should be balanced with the minimal invasiveness of the technique and the possibility of repeating it with no additional morbidity and considering the relatively long recurrence time that in our cases was 17months in mean with no deterioration in function. Breaking industry news, startup innovation alerts & emerging HealthTech News. Google Scholar. 2006;30:65963. Data on 43 consecutive female patients undergoing Altemeiers procedure for complete rectal prolapse were reviewed. At this point, the herniated Douglas pouch should be visible on the anterior circumference of the inner intestinal loop. Surgery puts the rectum back in place. is for limited procedures only in the Female Reproductive System. Surg Laparosc Endosc. volume19, Articlenumber:1 (2019) There are also multiple examples in the ICD-10-PCS Reference Manual to help you better understand the procedure approaches. According to many researchers, there are between three and five ways in which the rectal prolapse can occur. <> 2016;20:695700. website belongs to an official government organization in the United States. or Hu B, Zou Q, Xian Z, Su D, Liu C, Lu L, Luo M, Chen Z, Cai K, Gao H, Peng H, Cao W, Ren D. Gastroenterol Rep (Oxf). The Altemeier repair: outpatient treatment of rectal prolapse. The physiological derangement in patients with rectal prolapse is complex, frequently showing impairment of the rectoanal inhibitory reflex, intermittent high-pressure rectal motor activity, disturbances in anorectal sampling and attendant pudendal neuropathy. The relationship between recurrence and age, BMI, previous rectal prolapse surgery, previous hysterectomy, levatorplasty, length of resected bowel and gender was evaluated using an independent-sample t-test, Pearsons chi-squared test or Fishers exact test. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). This would be coded as an open approach since the laceration has cut through the external body layers exposing the muscle. Arch Surg. Gut. At long-term follow-up functional results demonstrate a statistically significant decrease in the Obstructive Defecation Syndrome (ODS) score, but no statistically significant changes in the Vaizey score, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score and the urinary retention score. Technical and functional results after laparoscopic rectopexy to the promontory for complete rectal prolapse. MeSH 1992;35(9):8304. endobj Prospective study in 54 consecutive patients. The posterior vaginal wall is dissected by retracting the preperitoneal fat of the Douglas pouch posteriad. .gov The 2023 ICD-10-PCS is the latest code set revision and is valid for . Bader AM. Altemeier's procedure for rectal prolapse: analysis of long-term outcome in 60 patients. (Related-Samples Sign Test for paired data), Comparison of the preoperative and postoperative Vaizey scores. Surg Radiol Anat. The majority of rectal prolapse incidents have successful treatment results requiring surgery. @%OkPz0E,kn`4K0o]=m"'IT*c&)_'!`Qt"MV2B9v{=I]$WKpGj7 :}_,)1_8,UImv!UV(dh',;+`W(\b5Q# Color Dis. ICD-10-PCS 3 E 1 U 2023 ICD-10-PCS Procedure Code 3E1U48X; 2023 ICD-10-PCS Procedure Code 3E1U48X Irrigation of Joints using Irrigating Substance, Percutaneous Endoscopic Approach, Diagnostic. 2009;24(2):2017. Thereby it offers the advantages of minimal surgical stress and low post-operative morbidity and mortality. This approach includes procedures whereby the procedure is performed entirely by percutaneous endoscopic approach. The probability of recurrence at 48months was determined using the Kaplan-Meier method. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 576 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Gambee sutures are at each exposed part of the incision. Three changes that will be with us long after COVID-19, 6 Tips For Hosting Safe And Healthy Parties. BMC Surgery wcirocco27@yahoo.com PMID: 21178855 DOI: 10.1007/DCR.0b013e3181f22cef Abstract The Altemeier procedure for rectal prolapse: an operation for all ages The Altemeier procedure for rectal prolapse: an operation for all ages Author William C Cirocco 1 Affiliation 1 Shawnee Mission Medical Center, Shawnee Mission, Kansas, USA. All authors gave their final approval of the version to be published and are co-authors of the present paper. The procedure is known as the Altemeier perineal rectosigmoidectomy. Excision Procedures on the Rectum. Epub 2018 Dec 15. With bipolar scissors, the rectal wall undergoes transection. Examples of percutaneous approach are arterial/venous catheter placement, coil embolization of artery, drainage of subdural hemorrhage via burr hole, laser trabeculoplasty, and PTCA of the coronary artery. When reporting procedures on this list, facilities should capture both the CPT1 code representing the procedure performed and the . They divided complications into minor and major, taking major complications to include organ space infection, cardiac and thromboembolic events, ventilator dependence, pneumonia, return to the operating room, renal failure and sepsis. Using digital means, the lateral ligaments experience transection with their pathways running between the ligatures. UdA|gV?jB(rWPARO K;&EI)E}Ck)o "8&u\4;?@ 2003 Jul-Sep;68(3):185-91. 8600 Rockville Pike Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. A study conducted on the long-term outcome saw that out of 93 medical records reviewed, the Altemeier Perineal Rectosigmoidectomy is a relatively safe and effective operation with few complications or issues. No procedure is considered the best overall. PubMedGoogle Scholar. <> Patient satisfaction was determined using a simple numerical scale from 0 (not satisfied) to 10 (completely satisfied). A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. ADPtFnnV D%v-_~"`H=F;h/!3vt0a9k`9SL2n Abdominal approaches have been shown to be associated with lower rates of recurrence than perineal procedures after which rates of up to 58% have been reported [19, 23]. Rectal prolapse is not uncommon. Murad-Regadas SM, Pinto RA. A single copy of these materials may be reprinted for noncommercial personal use only. Google Scholar. ICD-10-PCS 0WQNXZZ is a specific/billable code that can be used to indicate a procedure. These cookies will be stored in your browser only with your consent. The CDC has published new codes that will be On December 21, CMS released the following Tr Weekly medical coding tips and coding education delivered directly to your inbox. Once the external prolapse has complete exposure, the Lone Star retractor is attached. You'll begin by drinking clear liquids and transition to solid foods. Ann Coloproctol. Rectal prolapse: a 10-year experience. 30days morbidity according to Clavien-Dindo classification [4] and 30days mortality were recorded. The exception is internal prolapses which are far more difficult to remedy as surgery may not be an option. The etiology is multifactorial and includes weakness of the pelvic floor, chronic constipation, multiple pregnancies, previous pelvic surgery and a deep pouch of Douglas [2]. <>>> The mean length of hospital stay was 6 [38] days. Rectal Prolapse Treatment & Management - Medscape Advances in preoperative risk assessment and management. government site. Gopal KA, Amshel AL, Shonberg IL, et al. Be in the know! Color Dis. Get new exclusive access to healthcare business reports & breaking news. J Anus Rectum Colon. The CMS ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The files in the Downloads section below contain information on the ICD-10-PCS COVID-19 updates effective with discharges on and after August 1, 2020. Before Fortunately, there is a procedure that can correct the condition. ICD-10-PCS 3E1U48X is a specific/billable code that can be used to indicate a . Dis Colon Rectum. 2004;240(2):20513. These are but a few examples of these selected approaches. Rectal prolapse surgery is a procedure to repair rectal prolapse, which occurs when the last part of the large intestine (the rectum) stretches and protrudes from the anus. 1984;7(6):37681. The median length of the resected bowel was 20 (1270) centimeters. Google Scholar. Twenty-eight (65%) patients had a previous history of cardiovascular disease, 13 (30%) a neurological or psychiatric disorder, and 30 (70%) had had previous pelvic surgery. This aids in exposing the dentate line. Accessed March 22, 2021. The site is secure. Prolapse of the rectum, long-term results of surgical treatment. Friedman R, Muggia-Sulam M, Freund HR. FOIA BMC Surg 19, 1 (2019). The 2021 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2021. Art. An announcement was also made at the September 2017 ICD-10 Coordination and Maintenance Committee meeting that FY 2018 would be the last GEMs file update. Risks vary, depending on surgical technique. It appears to be slightly more common in people who have the perineal procedure compared with an abdominal one. Dear Editor. This also requires the exposure of the sling of the levator ani. 45126. A different example of an open approach is repair of second-degree obstetrical laceration of the perineum. S Rita Clinic, Vercelli, Italy, Mario Trompetto,Roberta Tutino,Alberto Realis Luc,Gaetano Gallo&Giuseppe Clerico, Dept. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Epidemiologic aspects of complete rectal prolapse. Experience with the one-stage perineal repair of rectal prolapse. The physiological derangement in patients with rectal prolapse is complex, frequently showing impairment of the rectoanal inhibitory reflex, intermittent hig Dindo D, Demartines N, Clavien PA. You can decide how often to receive updates. Ris F, Colin JF, Chilcott M, Remue C, Jamart J, Kartheuser A. Colorectal Dis. Epub 2019 May 9. 45990 Anorectal EUA, no other procedure Anorectal Procedures 45999 Unlisted procedure, rectum Anorectal Procedures 46040 Abscess, I&D, perirectal, any type Anorectal Procedures 46200 Fissurectomy + flap Anorectal Procedures 46220 Papilla or tag, anal, excision Anorectal Procedures 46700 Stricture, anoplasty Anorectal Procedures Analysis of possible factors related to recurrence showed no statistical relationship to age, gender, BMI, ASA score, recurrent prolapse already repaired, previous hysterectomy, the length of resected bowel or the addition of a levatorplasty to the repair. PMC These 2020 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020. Resection-rectopexy had doubled the rate of complications than rectopexy alone [9]. Altemeiers procedure for complete rectal prolapse; outcome and function in 43 consecutive female patients. The 2020 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2020. sharing sensitive information, make sure youre on a federal HIA offers PRN support as well as, Reporting Intra-Aortic Balloon Pump (IABP) in ICD-10-PCS 5A02210, Find Your Routine: Increase Reading Speed to Maximize Productivity. 2012;14(3):3628. Prospective comparison of faecal incontinence grading systems. (XLSX 20 kb). Please enable it to take advantage of the complete set of features! Free 2023 ICD-10-PCS Procedure Codes - ICD10Data.com Cite this article. 2015;19(9):5215. 2005;94(3):20710. Perineal excision of rectal procidentia in elderly high-risk patients. Accessed March 22, 2021. Altemeier Procedure: What To Expect - Healthcare Weekly Or is there a seperate code for the levatorplasty code that I can bill in addition to the 45130 code. 2023 BioMed Central Ltd unless otherwise stated. All patients received a complete bowel preparation, antibiotic prophylaxis (Cefazolin and Metronidazole) and thromboembolic prophylaxis (low-molecular-weight heparin). Trompetto, M., Tutino, R., Realis Luc, A. et al. An official website of the United States government. She says she has pain and rectal bleeding. This site needs JavaScript to work properly. and transmitted securely. Fleming et al. Perineal Rectosigmoidectomy (Altemeier Procedure) None. The sigmoid receives transection at a level where there is a stretch in the colon. Hoel AT, Skarstein A, Ovrebo KK. Disclaimer. Coding Root Operations with ICD-10-PCS: Understanding Drainage - AHIMA ANESTHESIA General endotracheal anesthesia. (Additionalfile1). ,Lm-Y6+k715AK.66c-')>9Vc Wy#Wp}0s. Bethesda, MD 20894, Web Policies As previously suggested, patients with complete rectal prolapse should be preoperatively assessed holistically with a record made of fecal incontinence, constipation, dysuria or urinary retention and urinary incontinence [8]. One patient showed an improvement in urinary retention but in all other patients the score was unchanged (p=1.000). Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. x\r6}wT RL&Z8kWa&2EKR[dbY$H6NN7@_]U>"X~~vcgfsvF?t~wyFsx2gcaase{Aqj# /B[J-$k{~8>Tz@?0NA}#tyA-\!%(B lock The authors declare that they have no competing interests. Specific Documentation Needed for Accurate Coding. Demographic data including age, number and type of delivery, comorbidity, previous pelvic or perineal surgery, duration of symptoms, bowel function including frequency of defecation, urgency and incontinence, urinary function, body mass index (BMI) and American Society of Anesthesiologists (ASA) score were recorded.