ABSTRACT
The first description of perineal rectosigmoidectomy was provided by Miculicz. The first operation he reported was for an incarcerated, gangrenous prolapse, but he also treated five other patients with uncomplicated prolapse by perineal amputation.1 the operation was popular during the first half of the twentieth century, but a recurrence rate of over 50 percent reported from St Mark’s Hospital lessened surgeons’ enthusiasm for this procedure.1 Altemeier published a large series of patients with rectal prolapse treated by perineal rectosigmoidectomy with few recurrences.2 This revived interest in the procedure and earned him eponymous recognition. There have been a number of reported series of patients treated with this operation with variable recurrence rates and low morbidity.3 the role of concomitant levatoroplasty has not been the subject of a randomized trial, although observational studies suggest a role in improving postoperative continence.4
