Question

A young male patient presents with complete rectal prolapse. The surgery of choice is:

• A. Abdominal rectopexy
• B. Delorme's procedure
• C. Anterior resection
• D. Goodsall's procedure

Hint:

Young and fit favors the durable abdominal route.

Answer 1

The Correct Option is A

Step 1: Complete rectal prolapse (procidentia) is full-thickness protrusion of the rectum through the anus. Definitive treatment is surgical, and the operative route is chosen partly by the patient's fitness.
Step 2: In a young, fit patient, the abdominal approach is preferred because it gives the most durable repair with the lowest recurrence. Abdominal rectopexy fixes the mobilised rectum to the sacral promontory and corrects the prolapse.
Step 3: Delorme's procedure (option B) is a perineal operation reserved mainly for elderly or unfit patients or short prolapses; it has higher recurrence and is not first choice in a young fit man.
Step 4: Anterior resection (option C) alone is not the standard primary operation for prolapse; resection rectopexy may be used in selected cases but plain anterior resection is not the answer here.
Step 5: Goodsall's rule/procedure (option D) relates to anal fistula tracks and has nothing to do with rectal prolapse, so it is a distractor.
Conclusion: The correct answer is A. Abdominal rectopexy.