Room for improvement? Evaluating the accuracy of referrals for rectal prolapse to three tertiary care medical centres
Fuente:
Wiley Open Access
Salvato in:
| Autori principali: | , , , , , , , , , |
|---|---|
| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2026
|
| Soggetti: | |
| Accesso online: | |
| Tags: |
Aggiungi Tag
Nessun Tag, puoi essere il primo ad aggiungerne!!
|
| _version_ | 1867006684681994241 |
|---|---|
| author | Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady |
| author_facet | Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady |
| collection | Wiley Open Access |
| contents | Room for improvement? Evaluating the accuracy of referrals for rectal prolapse to three tertiary care medical centres Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady Colorectal Disease Abstract Aim Rectal prolapse is a full‐thickness intussusception of the rectum beyond the anal canal. It is often mistaken for other anorectal pathologies, leading to inaccurate referrals to colorectal surgeons and inappropriate management. However, the frequency of misdiagnosis is not well characterized. We aimed to assess the diagnostic accuracy of rectal prolapse referrals to three tertiary medical centres. Methods This is a retrospective study of patients referred for rectal prolapse to colorectal surgeons at the Mayo Clinic in Rochester, Jacksonville, and Phoenix from 2020 to 2024. The primary outcome is the accuracy of rectal prolapse diagnosis. The secondary outcomes are factors that correlate with diagnostic accuracy. Results Rectal prolapse was inaccurately diagnosed in 38.7% (186/480) of patients. Among misdiagnosed patients, the correct diagnosis was haemorrhoids (68.0%, n = 134), pelvic floor dysfunction (24.3%, n = 48) and rectocele (18.7%, n = 37). A diagnosis of rectal cancer was found in 3 patients (1.5%). The most common presenting symptoms were protrusion (66.3%, n = 345) and bleeding (33.6%, n = 175). Among the referring physicians, only 50.5% ( n = 227) performed an anorectal examination. Overall, there was significant variability in diagnostic accuracy across different specialties, with the highest accuracy from colorectal practices (84.0%) and the lowest from urologists (50.0%). Internal medicine physicians had a lower diagnostic accuracy with anorectal examination than without, though it did not reach statistical significance (44.0% vs. 59.5%, p = 0.2). Conclusion Over one‐third of rectal prolapse referrals were incorrectly diagnosed. This study highlights the opportunity for further training of referring providers on anorectal pathologies to improve diagnostic accuracy which could reduce treatment delays and optimize clinical outcomes. 10.1111/codi.70418 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/codi.70418 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_70418 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Room for improvement? Evaluating the accuracy of referrals for rectal prolapse to three tertiary care medical centres Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady Colorectal Disease Room for improvement? Evaluating the accuracy of referrals for rectal prolapse to three tertiary care medical centres Mayar H. Alatout Andrew Saleeb Hoe Yan Hor Rania Mansour Tonia M. Young‐Fadok Nitin Mishra David A. Etzioni Sherief Shawki Amit Merchea Justin T. Brady Colorectal Disease Abstract Aim Rectal prolapse is a full‐thickness intussusception of the rectum beyond the anal canal. It is often mistaken for other anorectal pathologies, leading to inaccurate referrals to colorectal surgeons and inappropriate management. However, the frequency of misdiagnosis is not well characterized. We aimed to assess the diagnostic accuracy of rectal prolapse referrals to three tertiary medical centres. Methods This is a retrospective study of patients referred for rectal prolapse to colorectal surgeons at the Mayo Clinic in Rochester, Jacksonville, and Phoenix from 2020 to 2024. The primary outcome is the accuracy of rectal prolapse diagnosis. The secondary outcomes are factors that correlate with diagnostic accuracy. Results Rectal prolapse was inaccurately diagnosed in 38.7% (186/480) of patients. Among misdiagnosed patients, the correct diagnosis was haemorrhoids (68.0%, n = 134), pelvic floor dysfunction (24.3%, n = 48) and rectocele (18.7%, n = 37). A diagnosis of rectal cancer was found in 3 patients (1.5%). The most common presenting symptoms were protrusion (66.3%, n = 345) and bleeding (33.6%, n = 175). Among the referring physicians, only 50.5% ( n = 227) performed an anorectal examination. Overall, there was significant variability in diagnostic accuracy across different specialties, with the highest accuracy from colorectal practices (84.0%) and the lowest from urologists (50.0%). Internal medicine physicians had a lower diagnostic accuracy with anorectal examination than without, though it did not reach statistical significance (44.0% vs. 59.5%, p = 0.2). Conclusion Over one‐third of rectal prolapse referrals were incorrectly diagnosed. This study highlights the opportunity for further training of referring providers on anorectal pathologies to improve diagnostic accuracy which could reduce treatment delays and optimize clinical outcomes. 10.1111/codi.70418 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Room for improvement? Evaluating the accuracy of referrals for rectal prolapse to three tertiary care medical centres |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.70418 |