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Review
. 2025 Aug 14;29(1):159.
doi: 10.1007/s10151-025-03198-0.

Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis

Hannaneh Yousefi-Koma #  1   2 , Yassin Rahnama #  1   2 , Dorsa Najari  1   3 , Fatemeh Fathabadi  1 , Mojtaba Sedaghat  4 , Alireza Kazemeini  1   5 , Mohammad Reza Keramati  1   5 , Amir Keshvari  1   5 , Mohammad Sadegh Fazeli  1   5 , Behnam Behboudi  1   5 , Seyed Mohsen Ahmadi-Tafti  6   7
Affiliations
Review

Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis

Hannaneh Yousefi-Koma et al. Tech Coloproctol. .

Abstract

Objectives: Rectal prolapse is a serious but not life-threatening condition. It can involve many complications, including quality-of-life changes. Surgical intervention is the standard medical treatment for these patients. In this article, we aim to investigate the quality-of-life outcomes in patients undergoing rectal prolapse surgery, compare different surgical methods, and assess different quality-of-life questionnaires to study these patients.

Data sources: We conducted a systematic literature search on PubMed, Scopus, ScienceDirect, and Embase.

Study selection: A total of 4916 studies were screened, resulting in a final 34 included studies, and 20 were included in the meta-analysis.

Interventions: Data were extracted from studies comparing the quality of life in rectal prolapse patients before and after surgery.

Main outcome measures: Except for one, all included studies reported improved quality-of-life scores. Different instruments were used to examine these patients' quality of life, but SF-36 was implemented most frequently. It comprises eight different domains, and these domains were reported in six different studies.

Results: All eight domains showed better outcomes after surgery. The final analysis was based on the surgical approach (perineal or abdominal) and showed no statistically significant superiority of any of the approaches.

Limitations: The high heterogeneity of the included studies.

Conclusion: Surgical intervention can improve the quality of life of rectal prolapse patients. However, there is no consensus on which surgical approach achieves the best outcomes. Different instruments are used to evaluate the quality of life in these patients, but there is no specific questionnaire to assess this.

Keywords: Colorectal surgery; Prolapse surgery; QoL queastionnaire; Quality-of-life; Rectal prolapse; Surgery outcome.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that there is no conflict of interest. Ethical approval: This study was conducted in full accordance with the ethical principles outlined in the Declaration of Helsinki. It was approved by the Ethics Committee of the Tehran University of Medical Sciences, Tehran, Iran, under approval number IR.TUMS.MEDICINE.REC.1403.451. Informed consent: For this type of study, formal consent is not required.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of included studies
Fig. 2
Fig. 2
Health-related quality of life, total score
Fig. 3
Fig. 3
SF-36, Physical functioning
Fig. 4
Fig. 4
Forest plot demonstrating pooled analysis of physical activity quality of life
Fig. 5
Fig. 5
Forest plot demonstrating pooled analysis of bodily pain domain of the SF-36 Quality of Life Questionnaire
Fig. 6
Fig. 6
Forest plot demonstrating pooled analysis of studies’ general health scores of SF-36 Quality of Life Questionnaire
Fig. 7
Fig. 7
Forest plot demonstrating pooled analysis of studies’ SF-36 Quality of Life Questionnaire vitality scores
Fig. 8
Fig. 8
Forest plot demonstrating pooled analysis of studies’ scores evaluating social role performance on the SF-36 Quality of Life Questionnaire
Fig. 9
Fig. 9
Forest plot demonstrating pooled analysis of studies’ scores evaluating emotional role performance on the SF-36 Quality of Life Questionnaire
Fig. 10
Fig. 10
Forest plot demonstrating pooled analysis of the mental health domain on the SF-36 Quality of Life Questionnaire
Fig. 11
Fig. 11
Subgroup analysis of the surgical methods and QoL score
Fig. 12
Fig. 12
Forest plot demonstrating pooled analysis of the recurrence rate
Fig. 13
Fig. 13
Summary plot of risk of bias assessment of included studies. A Non-randomized studies assessed by ROBINS-I. B Randomized controlled studies assessed by RoB 2
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