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SENIOR REGISTRAR IN ORTHOPAEDICS, KING'S HOSPITAL, LONDON SUMMARYOne hundred and fifty cases of complete rectal prolapse have been operated on using an Ivalonsponge implant, the first case being over 13 years ago. Seventy per cent of the patients were over the age of 60 years. The operation has a low mortality-and morbidity-rate. Repair. using Ivalon sponge was 96 per cent successful in the cure of complete prolapse and the method appears to stand the test of time well. IN 1959 Wells first described the use of polyvinyl alcohol sponge in the repair of rectal prolapse. A follow-up study (Morgan and Wells, 1962) suggested that this technique provided a very effective method of controlling rectal prolapse and that it also went some way towards helping in the management of the notoriously difficult functional problems that beset these patients, in that 50 per cent of them became continent postoperatively and, as a result of this, were able subsequently to manage their difficult bowel habits more easily.We have delayed publication of our figures for two reasons: first, in order to gain a significant number of patients for a worth-while statistical evaluation, and, secondly, to see how this operation stands the test of time. In the management of complete rectal prolapse these two considerations are important.The vast amount of literature published on this subject contains a number of extravagant claims based on small series of cases which have been insufficiently 61 followed up. We have taken considerable trouble to avoid this error in the present series. MATERIALSThis series of 150 patients was operated on by two of us (C. N. M. and N. H. P.) between January, 1959, and May, I972 (Table I ) . There were 127 females and There were I I late deaths (7.3 per cent) in the seriesthese patients died from causes unconnected with the original operation or complaint of rectal prolapse. In none of these patients was there any history of recurrence up to the time of death. Unfortunately, 42 patients (28 per cent) have been lost to follow-up because they had originally come from distant parts of the United Kingdom or from abroad. In none of these latter patients was there any history of recurrent prolapse up to the time of their disappearance from follow-up. Thus, there is a total of 93 cases (62 per cent of the number operated on) available for study.