What is the prognosis of pediatric rectal prolapse?

Updated: Nov 12, 2018
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Most cases reduce spontaneously. Otherwise, venous stasis, edema, and ulceration ensure. Longstanding or frequent recurrent prolapse episodes lead to proctitis.

Approximately 10% of patients who experience rectal prolapse as children continue to be symptomatic into adulthood. Over 90% of children who prolapsed during the first 3 years of life, respond to conservative treatment by age 6. Spontaneous resolution is much less likely in children who develop their first episode of prolapse after age 4 years.

After a surgical rectopexy, continence is achieved in 92% of patients. Resective procedures demonstrate lower recurrence rates. Recovery of continence after surgery is not immediate, it may take up to a year.

Nwako et al reported a 100% success rate with the Lockhart-Mummery procedure, which involves packing the presacral space with gauze through a posterior approach, with excision of the prolapsed mucosa. [23]

Hight et al recommend linear cauterization of the rectal mucosa, with a 98% success rate in 72 patients. [24]

 


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