To make large-scale recruitment feasible, and to maximise the clinical relevance of the eventual findings, the National Rectal Prolapse Trial is designed to fit in with routine practice with a minimum of extra tests and investigations over those that would normally be required. About 1000 patients will be recruited into the trial over a 3 year period and followed for a minimum of 3 years.

The primary measures of efficacy will be recurrence of rectal prolapse for randomisation 1 and bowel function for randomisation 2. Patients will have rigid sigmoidoscopy before the operation and information will be collected on the following:

• Demography

• Risk factors

• Defaecatory performance (including Kamm score)

• Quality of life

Additional investigations are optional and will be undertaken with the consent of the patient and at the availability of the centre.  Investigations include:

• Colonic transit study

• Sensory

• Motor function investigations

• Pudendal nerve terminal motor latency

• Anal ultrasound