Eleven patients (nine women) with persistent faecal incontinence after rectopexy for rectal prolapse were treated by postanal repair. Follow-up data, including clinical and anorectal physiology, at 5-8 years (median 76 (range 64-95) months) were available for nine patients. At long-term follow-up, seven of the nine patients had improved continence (two were continent to solid and liquid stools, and five to solid stool). One patient required a colostomy. Median (range) physiological findings before and after postanal repair in the nine patients were: anal canal length 2.3 (1.5-3.0) versus 3.5 (2.0-5.5) cm (P<0.05); resting anal pressure 20 (0-49) versus 35 (10-55) cmH(2)O (P<0.05); perineal descent 2 (1-3) versus 0 (3 to -0.2) cm; and mean pudendal nerve terminal motor latency 2 35 (2.0-3.1) versus 2.85 (2.3-3.4) ms.