Surgery may be indicated for severe cases of SRUS (either severe symptoms, severe ulceration, or significant associated anatomical defect such as prolapse), or when conservative measures fail. Some authors state that most patients do not benefit from surgery. Overall, up to 33% of SRUS patients end up requiring surgery. A systematic review reported that SRUS improved in 77% of patients who underwent any type of surgery, however 52% of cases developed a later recurrence of the condition. It has been suggested that any treatment which only addresses the ulcer without correcting the underlying causes will typically lead to recurrence.
