In the case of recurrence after rectal prolapse surgery, the surgical procedures were performed with the opposite approaches considering the patient’s condition. If the patient initially underwent an abdominal approach, reoperation was performed with a perineal approach. When the risks of general anesthesia are high, such as when the patient is elderly, has a high ASA PS classification, or has a severe underlying disease, perineal approach surgery under spinal anesthesia was performed according to the recommendation of the anesthesiologist. For patients who underwent radiotherapy in the abdominal cavity, abdominal approach was selected. All elective rectal prolapse surgeries were performed by 2 experienced colorectal surgeons.