{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:17:47Z","timestamp":1791195467814,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T00:00:00Z","timestamp":1375142400000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Rectal prolapse is a profoundly disabling condition, occurring mainly in elderly and parous women. There is no accepted standard surgical treatment, with previous studies limited in methodological quality and size.\n                      <jats:styled-content style=\"fixed-case\">PROSPER<\/jats:styled-content>\n                      aimed to address these deficiencies by comparing the relative merits of different procedures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      In a pragmatic, factorial (2\u00a0\u00d7\u00a02) design trial, patients could be randomised between abdominal and perineal surgery (i), and suture\n                      <jats:italic>vs<\/jats:italic>\n                      resection rectopexy for those receiving an abdominal procedure (ii) or Altemeier's\n                      <jats:italic>vs<\/jats:italic>\n                      Delorme's for those receiving a perineal procedure (iii). Primary outcome measures were recurrence of the prolapse, incontinence, bowel function and quality of life scores (Vaizey, bowel thermometer and\n                      <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\n                      \u20105D) measured up to 3\u00a0years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and ninety\u2010three patients were recruited: 49 were randomised between surgical approaches (i); 78 between abdominal procedures (ii); and 213 between perineal procedures (iii). Recurrence rates were higher than anticipated, but not significantly different in any comparison: Altemeier's\n                      <jats:italic>vs<\/jats:italic>\n                      Delorme's 24\/102 (24%) and 31\/99 (31%) [hazard ratio (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      ) 0.81; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.47, 1.38;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.4]; resection\n                      <jats:italic>vs<\/jats:italic>\n                      suture rectopexy 4\/32 (13%) and 9\/35 (26%) (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      0.45; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.14, 1.46;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.2); perineal\n                      <jats:italic>vs<\/jats:italic>\n                      abdominal 5\/25 (20%) and 5\/19 (26%) (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      0.83; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.24, 2.86;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.8). Vaizey, bowel thermometer and\n                      <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\n                      \u20105D scores were not significantly different in any of the comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      No significant differences were seen in any of the randomised comparisons, although substantial improvements from baseline in quality of life were noted following all procedures\n                      <jats:bold>.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.12177","type":"journal-article","created":{"date-parts":[[2013,3,5]],"date-time":"2013-03-05T12:27:40Z","timestamp":1362486460000},"page":"858-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":263,"title":["<scp>PROSPER<\/scp>\n                    : a randomised comparison of surgical treatments for rectal prolapse"],"prefix":"10.1111","volume":"15","author":[{"given":"A.","family":"Senapati","sequence":"first","affiliation":[{"name":"Queen Alexandra Hospital Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. G.","family":"Gray","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. J.","family":"Middleton","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Harding","sequence":"additional","affiliation":[{"name":"Sexual Health and HIV Research Department Whittall Street Clinic Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Hills","sequence":"additional","affiliation":[{"name":"Haematology Clinical Trials Unit Cardiff University School of Medicine Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. C. M.","family":"Armitage","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Nottingham University Hospitals Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M. A.","family":"Northover","sequence":"additional","affiliation":[{"name":"St Mark's Hospital for Intestinal and Colorectal Disorders London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PROSPER Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/b136174"},{"key":"e_1_2_13_3_1","first-page":"CD001758","article-title":"Surgery for complete rectal prolapse in adults","volume":"8","author":"Tou S","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01647997"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197106010-00018"},{"key":"e_1_2_13_6_1","first-page":"CD001758","article-title":"Surgery for complete rectal prolapse in adults","volume":"2","author":"Bachoo P","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810253"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00341225"},{"key":"e_1_2_13_9_1","first-page":"145","article-title":"A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse","volume":"174","author":"McKee RF","year":"1992","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_13_10_1","unstructured":"PROSPER protocol.http:\/\/www.birmingham.ac.uk\/Documents\/college-mds\/trials\/bctu\/prosper\/prosper-protocol-v2-dec05.pdf."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.44.1.77"},{"key":"e_1_2_13_12_1","first-page":"199","article-title":"EuroQoL \u2010 a new facility for the measurement of health\u2010related quality of life","volume":"3","author":"EuroQoL Group","year":"1990","journal-title":"Health Policy"},{"key":"e_1_2_13_13_1","unstructured":"DolanP GudexC KindP. 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