Outcomes following sclerotherapy for mucosal rectal prolapse with oily phenol injection: single-centre review

Abstract

Aim of the study

To review the outcomes of injection sclerotherapy with oily phenol for mucosal rectal prolapse.

Methods

Retrospective case note review of all children who underwent sclerotherapy with oily phenol injection as primary surgical intervention for mucosal rectal prolapse, from January 2007 to December 2015.

Main results

A total of 31 patients were identified. Mean age at presentation was 4.8 years (range 5 months–12 years). 23 patients with mucosal rectal prolapse underwent injection sclerotherapy with oily phenol as primary procedure. Patients with full-thickness rectal prolapse (n = 6) and 2 with mucosal prolapse who had Thiersch stitch were excluded from the study. The cause for mucosal rectal prolapse was considered to be due to constipation (n = 15), idiopathic (n = 7), spina bifida (n = 1). Follow-up was for minimum 6 months (median = 4 years; range 6 months–17 years). Recurrence following injection sclerotherapy with oily phenol requiring further procedures was 30.4% (7/23).

Conclusions

Injection sclerotherapy with oily phenol is a safe, effective and minimally invasive primary treatment option for mucosal rectal prolapse not responding to conservative management. In case of recurrence, a cautious re-examination under anaesthesia should be undertaken to exclude a missed full-thickness rectal prolapse before reinjecting.