FP4.11 - Patient Reported Outcome Measures (PROMs) of Altemeier’s Procedure

Abstract

Abstract Rectal prolapse (RP) is a debilitating condition that can be managed using Altemeier’s procedure (AP). We aimed to evaluate patient-reported long-term outcomes following AP focusing on symptoms, post-procedure pain and overall satisfaction. Patients who underwent AP in a District General Hospital between January 2015 and December 2022 were reviewed. Patients were contacted by telephone and interviewed using a standardised questionnaire. Likert scores and a Numeric Rating Scale (NRS) were used to assess functional outcome and pain respectively. Indication for surgery, recurrence, and data on further procedures were also collected. Out of 38 patients identified, 20 who underwent AP over the study period (mean age 78 years, s.d. 7.44, Female=20) were contactable and included in our study. In combination with RP, indications for surgery included faecal incontinence, obstructive defaecation symptoms, pain and rectal bleeding. At the time of follow up, 75% of patients reported their initial symptoms to be slightly or much better, 10% reported no change and 15% reported slightly worse symptoms. Prior to AP, 45% of patients reported no pain compared to 70% post-procedure. Severe pain was reported by 30% of patients pre-Altemeier’s compared to five percent post-procedure. Recurrence of RP occurred in 40% patients. 30% of patients required a second procedure. Overall, 80% of patients were satisfied with their outcome and 90% would recommend AP to friends and family. Most patients reported better functional outcome and good overall satisfaction, despite 30% requiring a further procedure. Our study was limited by small sample size and subjectiveness of patient reporting.