• Ilija Milev Department of Surgery, Clinical Hospital-Shtip, Faculty of Medical Sciences, Goce Delchev University in Stip, North Macedonia
  • Aleksandar Mitevski Department of Surgery, Re-Medica General Hospital, Faculty of Medical Sciences, Goce Delchev University in Stip, North Macedonia
  • Panche Karagjozov Clinic for Digestive Surgery, Faculty of Medicine, Ss. Chyril and Methodius University in Skopje, North Macedonia


Complete rectal prolapse or procidentia is a protrusion of the rectum with all its layers trough the anus. The incidence ranges between 0.79-6.08 per 100 000. The diagnosis could be easily established on examination, or in cases with internal rectal prolapse by defecography. Weakness of the anal sphincters is very common with advance disease and approximately 50% to 75% of patients experience some form of fecal incontinence. Symptomatic rectal prolapse is an indication for operation. Over 100 operative procedures have been described for the treatment of rectal prolapse and they all can be categorized as transabdominal and transperineal procedures. Delorme procedure is a transperineal procedure that consists of resection a cylindrical mucosal flap and plication of the protruded rectal musculature. We are presenting two, old and debilitated patients with procidentia and complete fecal incontinence, successfully treated with Delorme procedure. The results of the treatment were remarkable regarding both the prolapse and the fecal incontinence. We are concluding that for the surgeon who is already familiar with other anorectal procedures, Delorme procedure is relatively simple and easy to learn, with excellent structural and functional results even in very poor risk patients with long segment rectal prolapse.

Keywords: rectal prolapse, fecal incontinence, Delorme procedure.


1.Kwaan MR, Stewart Sr DB, Dunn K. Colon, Rectum, and Anus. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Kao LS, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz's Principles of Surgery, 11e. McGraw Hill; 2019. 1259-1329.
2.Rafferty JF. Rectal Prolaps. In: Beck DE, Wexner SD, Janice F. Rafferty JF. eds. Gordon and Nivatvongs’ Principles and Practice of Surgery for the Colon, Rectum, and Anus Fourth Edition, 4e. Thieme; 2020. 344-351.
3.Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94(3): 207-210.
4.Gordon PH. Rectal Procidentia. In: Gordon PH, Nivatvongs S. eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus. 3e. Informa Healthcare USA, Inc.;2007. 415-450.
5.Fleshman, Jr. JW, Lin AY. Benign Disorders of the Anorectum (Pelvic Floor, Fissures, Hemorrhoids, and Fistulas). In: Zinner MJ, Ashley SW, Hines O. eds. Maingot's Abdominal Operations, 13e. McGraw Hill; 2019. 2319-2376.
6.Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years' experience with the one-stage perineal repair of rectal prolapse. Ann Surg. 1971 Jun;173(6): 993-1006.
7.Delorme R. Sur le traitment des prolapses du rectum totaux pourl’excision de la muscueuse rectale ou rectocolique. Bull Mem Soc Paris. 100; 26: 499-518.
8.Tou S, Brown SR, Nelson RL. Surgery for complete (full-thickness) rectal prolapse in adults. Cochrane Database Syst Rev. 2015 Nov 24;2015(11):CD001758.
9.Goldstein SD, Maxwell PJ 4th. Rectal prolapse. Clin Colon Rectal Surg. 2011 Mar;24(1):39-45.
10.Tsunoda A. Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature. J Anus Rectum Colon. 2020 Jul 30;4(3):89-99.
11.Emile SH, Elfeki H, Shalaby M, Sakr A, Sileri P, Wexner SD. Perineal resectional procedures for the treatment of complete rectal prolapse: A systematic review of the literature. Int J Surg. 2017 Oct;46: 146-154.
12.Pescatori M, Interisano A, Stolfi VM, Zoffoli M. Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence. Int J Colorectal Dis. 1998;13(5-6):223-227.
13.Osman MM, Abd El Maksoud WM, Gaweesh YS. Delorme's operation plus sphincteroplasty for complete rectal prolapse associated with traumatic fecal incontinence. J Biomed Res. 2015 Jul;29(4):326-3 31.
14.Hyun K, Yoon SG. Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse. Ann Coloproctol. 2019 Oct;35(5):262-267.
15.Warwick AM, Zimmermann E, Boorman PA, Smart NJ, Gee AS. Recurrence rate after Delorme’s procedure with simultaneous placement of a Thiersch suture. Ann R Coll Surg Engl. 2016; 98(6):419–421.
How to Cite
MILEV, Ilija; MITEVSKI, Aleksandar; KARAGJOZOV, Panche. DELORME PROCEDURE FOR FULL THICKNESS RECTAL PROLAPSE WITH COMPLETE FECAL INCONTINENCE: REPORT OF TWO CASES. Journal of Morphological Sciences, [S.l.], v. 5, n. 3, p. 13-19, dec. 2022. ISSN 2545-4706. Available at: <>. Date accessed: 19 june 2024.