Our Summary

This research paper looks at the complications of rectal prolapse repair, which is an issue that can occur after surgery for anorectal malformations (ARM). The study was based on a review of patient cases at a single institution from 2014 to 2024.

Out of 1275 patients with ARM, 85 had rectal prolapse repair. It was found that a recurrence of the prolapse needing another repair operation happened in just over 30% of the cases. Additionally, about 32% of the patients developed a significant post-operative stricture (a narrowing or tightening of a section of the rectum), and most of these patients underwent another procedure to fix this.

Interestingly, the study found that patients who didn’t show symptoms of their prolapse initially were more likely to develop a stricture. Also, patients with an ostomy (an artificial opening in an organ) and those who had an ostomy takedown at the same time with prolapse repair were more likely to have a recurring prolapse.

The paper concludes that post-operative stricture is a significant concern after prolapse repair and needs close monitoring. The researchers suggest that patients without symptoms should be treated with caution, and all patients should be made aware of the risk of developing a stricture after the operation.

FAQs

  1. What complications can occur after rectal prolapse repair surgery?
  2. What percentage of patients may need another repair operation due to a recurrence of the prolapse?
  3. How does having an ostomy or an ostomy takedown at the same time with prolapse repair influence the likelihood of recurring prolapse?

Doctor’s Tip

A doctor might advise a patient undergoing rectal prolapse surgery to be aware of the risk of developing a post-operative stricture and to closely monitor for symptoms. Patients without initial symptoms should still be cautious, and those with an ostomy or who undergo an ostomy takedown at the same time as the prolapse repair may be at higher risk for complications. It is important for patients to follow up with their healthcare provider regularly after surgery to address any potential issues.

Suitable For

Overall, patients who are typically recommended for rectal prolapse surgery are those who have symptomatic rectal prolapse that significantly impacts their quality of life. These patients may experience symptoms such as difficulty with bowel movements, fecal incontinence, or a feeling of fullness or pressure in the rectum. Additionally, patients who have tried conservative treatments for rectal prolapse without success may be candidates for surgery.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if rectal prolapse surgery is the best course of action for their individual situation. Additionally, patients should be aware of the potential complications, such as post-operative stricture, and be prepared for close monitoring and follow-up care after the surgery.

Timeline

Before rectal prolapse surgery, a patient may experience symptoms such as the feeling of a bulge or protrusion from the rectum, difficulty controlling bowel movements, constipation, and rectal bleeding. They may also undergo diagnostic tests such as a physical examination, colonoscopy, and imaging studies to confirm the diagnosis.

After rectal prolapse surgery, the patient will typically experience some pain, discomfort, and swelling in the rectal area. They may also need to follow a special diet, take pain medication, and practice good hygiene to prevent infection. The patient will need to avoid heavy lifting and strenuous activities for a period of time to allow the area to heal properly.

In the weeks and months following surgery, the patient will have follow-up appointments with their surgeon to monitor their recovery and address any concerns. It is important for the patient to adhere to their surgeon’s post-operative instructions and attend all scheduled appointments to ensure a successful outcome.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rectal prolapse surgery?
  2. How likely is it that the prolapse will recur after the surgery?
  3. What is the likelihood of developing a post-operative stricture, and how is it typically treated?
  4. Are there any specific factors that may increase the risk of complications or recurrence?
  5. What is the recommended follow-up care and monitoring after the surgery?
  6. Are there any lifestyle changes or precautions that should be taken to prevent complications or recurrence?
  7. What is the success rate of rectal prolapse surgery in terms of symptom improvement and long-term outcomes?
  8. Are there any alternative treatment options to consider before opting for surgery?
  9. How experienced is the surgical team in performing rectal prolapse repair procedures?
  10. Are there any specific instructions or guidelines to follow before and after the surgery to optimize recovery and minimize complications?

Reference

Authors: Read MA, Pruitt LCC, Rachwal B, Griffin KL, Wood RJ, Gasior AC. Journal: J Pediatr Surg. 2025 Jul;60(7):162319. doi: 10.1016/j.jpedsurg.2025.162319. Epub 2025 Apr 7. PMID: 40204270