Mucosal Injection as treatment for rectal prolapse in children with corrected anorectal malformation

Abstract BackgroundThe aim of this study was to explore anal mucosal injection of bulking agents as treatment for rectal prolapse in patients with corrected anorectal malformations. To our knowledge, no prior research has been published on this matter.Despite rectal prolapse being a common occurrence, treatment is poorly standardized due to a small number of cases and the pathogenesis of rectal prolapse differing from that in healthy populations, often rendering usual treatments unsuccessful. Materials and MethodsWe used bulking agents usually used in endoscopic treatment of vesicoureteral reflux (Deflux, Vantris) to treat rectal prolapse in children with corrected anorectal malformations. We retrospectively analyzed pre- and intraoperative characteristics and postoperative outcomes. Patients were recruited from our consultancy for patients with anorectal malformations.Results16 children were included. Average operating time was 31 minutes.No intraoperative complications were recorded. Two patients showed minor bleeding, which ceased without further surgical interventions. Three patients developed local erythema/infection, which improved under a short course of antibiotics. Follow up ranged between 6 weeks and 76 months. One patient showed partial recurrence. No further complications were recorded.ConclusionsMucosal injection of bulking agents is a safe, minimally invasive and feasible treatment for rectal prolapse in this patient collective. In the absence of major complications, surgery time and length of hospital stay proved to be short. Further studies with larger samples, long-term follow up and direct comparison with alternative treatments should be conducted to explore this opportunity further and optimize treatment.