Long-term recurrence and quality of life after open Wells rectopexy: A single-center retrospective cohort study

Abstract

Aim: Rectal prolapse significantly impairs quality of life, and surgery remains the mainstay of treatment in adults. Despite numerous techniques, no gold standard exists, and long-term data on open posterior rectopexy are limited. This study aimed to evaluate long-term recurrence and quality of life outcomes following open Wells (posterior mesh) rectopexy.Methods: This single-center retrospective cohort study included adult patients who underwent elective open Wells rectopexy between January 2015 and August 2025. Data were collected from hospital records and follow-up telephone interviews. Outcomes included recurrence and disease-specific quality of life, assessed using the Patient Assessment of Constipation–Quality of Life (PAC-QOL) questionnaire.Results: Twenty-one patients were included, with a mean age of 46.8 ± 16.5 years, and 61.9% were female. During a median follow-up of 60 months (IQR: 44), rectal prolapse recurrence occurred in 14.3% of patients, and incisional hernia was observed in 23.8%. The median PAC-QOL score was 0.67 (1.71), and higher PAC-QOL scores were significantly associated with longer postoperative hospital stay (p = 0.02).Conclusion: Open Wells posterior mesh rectopexy yields acceptable long-term outcomes, but minimally invasive approaches may be preferred due to lower recurrence and complication rates. It remains an option in selected patients.