<prompt> Recurrent prolapse of the rectum in old patients is treated by:Thiersch wiringDigital repositionExcisionRipsteins operation  <response>: Rectal prolapse- Rectal Prolapse is of two types Mucosal mainly in children Full thickness mainly in adults Causes of rectal prolapse common causes- Protein Energy Malnutrition- Worm infestation- Diarrhea Rare causes:- Sacral agenesis- Meningomyelocele Management- Depends on cause- Conservative Management for common causes- If patient is not responding - LOKHA - MUMMARY RECTOPEXY- For rare causes - THIERSCH ANAL WIRING - For Adults - Rectopexy Abdominal approach Rectopexy Perineal approachRectopexy Abdominal Approach- Decreased recurrence rate- Associated with high morbidity- Preferred in young patients- Types of rectopexy W - Wells A - Abdominal R - Ripstein- RESECTION RECTOPEXY Goldman - Fryberg Rectopexy Perineal Approach- Increased recurrence rate- Associated with low morbidity- For old frail patients- Types of rectopexy P - Perineal A - Altmaier D - Delorme- THIERSCH ANAL WIRING 