Risk factors and clinical characteristics of rectal prolapse in young patients

Abstract

Background. - Rectal prolapse is a relatively common condition in children and elderly patientsbut uncommon in young adults less than 30 years old. The aim of this study is to identify riskfactors and characteristics of rectal prolapse in this group of young patients and determinesurgical outcome. Methods. - Adult patients younger than 30 years old with rectal prolapse treated surgicallybetween September 1994 and September 2012 were identified from an IRB-approved database.Demographics, risk factors, associated conditions, clinical characteristics, surgical managementand follow-up were recorded. Results. - Forty-four (females 32) patients were identified with a mean age of 23 years old.Eighteen (41%) had chronic psychiatric diseases requiring treatment and these patients expe-rienced significantly more constipation than non-psychiatric patients (83% vs. 50%; P = 0.024).Thirteen (30%) patients had previous pelvic surgery. The most common symptom at presentationwas a prolapsed rectum in 40 (91%) and hematochezia in 24 (55%). Twenty-four (55%) underwenta laparoscopic rectopexy, 14 (32%) open abdominal repair, and 6 (14%) had perineal surgery.The most common procedure was resection rectopexy in 21 (48%; 7 open; 14 laparoscopic). Ata median follow-up of 11 (range 1-165) months, 6 patients (14%) developed a recurrence. Conclusions. - Medication induced constipation in psychiatric patients and possible pelvic floorweakness in patients with previous pelvic surgery may be contributing factors to rectal prolapsein this group of patients.