Perianal submucosal ethanolamine oleate injection assisted abdominal suture rectopexy: a new technique for treatment of rectal prolapse in adults

ABSTRACT

This study was done on 51 adults with rectal prolapse to evaluate the ethanolamine oleate solution injection assisted by suture rectopexy in complete prolapse and alone in partial prolapse. It included 32 patients with complete rectal prolapse, 8 males and 24 females with age range from 20 to 64 years. After full mobilization of the rectum, four-non-absorbable sutures [Prolene sutures, No. 0] were used to fix it to the periosteum of the promontory of the sacrum. A spinal needle attached to an injection syringe was inserted through the skin just outside the mucocutaneous junction. Using a guiding finger in the rectum, the needle was passed through the perianal skin for about 10 cm above the anal verge. Then injection of ethanolamine oleate solution was done in the submucosal plain while we withdrew the needle outside. The injection was repeated in four quadrants at 6, 9, 12, 3 o'clock. Then the rectum was lightly packed with a gauze, which was removed at the following defecation. The results were very encouraging regarding a] Prolapse management, all patients were cured of their prolapse with no recurrence after follow up period ranged from 16 to 36 months, b] Continence regain, in grade 3 incontinence, 83.5% got full continence and the incidence was 100% in grade 2 and c] No constipation occurred which is a major complication of abdominal rectopexy. Injection alone was done in 19 patients with partial rectal prolapse [6 males and 13 females] with 68.4% success from the first trial and 10.5% success after the second injection. On conclusion, ethanolamine oleate solution injection is safe, effective and cheap method for treatment of partial rectal prolapse and assists abdominal rectopexy in complete prolapse