Classification and management of rectal prolapse after anorectoplasty for anorectal malformations

Giulia Brisighelli, Antonio Di Cesare, Anna Morandi, Irene Paraboschi, Lorena Canazza, Dario Consonni, Ernesto Leva

Research output: Contribution to journalArticle

Abstract

Purpose: To suggest a classification, describe the risk factors and management of rectal prolapse after anorectoplasty for anorectal malformations (ARMs). Methods: We classified prolapse as minimal (rectal mucosa visible with Valsalva manoeuvre), moderate (prolapse 5 mm without Valsalva) and compared patients with and without prolapse within our ARM-population. Results: Among 150 patients, 40 (27 %) developed prolapse: 25 minimal, 6 moderate, 9 evident. Prolapse affected 33 % of males (9 % of perineal fistulas, 38 % of bulbar, 71 % of prostatic, 60 % of bladder neck and 13 % without fistula) and 21 % of females (9 % of perineal, 30 % of vestibular, 50 % of cloacas, and 25 % without fistula). Risk factors for prolapse were: tethered cord (40 vs 24 %), vertebral anomalies (39 vs 24 %), laparoscopic-assisted anorectoplasty (LAARP) (75 vs 25 %), and colostomy at birth (49 vs 9 %). Redo anorectoplasty was not associated with prolapse. Symptoms were present in 11 patients (28 %): in 7 % with minimal, 33 % with moderate and 77 % with evident prolapse. Nine patients (2 moderate, 7 evident) underwent surgical correction. Conclusion: Severe ARMs, tethered cord, vertebral anomalies, colostomy, and LAARP predispose to rectal prolapse. Classifying prolapse allows to predict symptoms and need for surgical correction, and to compare outcomes among different centers.

Original languageEnglish
Pages (from-to)783-789
Number of pages7
JournalPediatric Surgery International
Volume30
Issue number8
DOIs
Publication statusPublished - 2014

Keywords

  • Anoplasty
  • Anorectal malformation
  • Anorectoplasty
  • PSARP
  • Rectal prolapse

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Fingerprint Dive into the research topics of 'Classification and management of rectal prolapse after anorectoplasty for anorectal malformations'. Together they form a unique fingerprint.

  • Cite this