Reduction of Rectal Prolapse Periprocedural Care

Updated: May 09, 2017
  • Author: Richard S Krause, MD; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS  more...
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Periprocedural Care

Patient Preparation

Anesthesia

In the case of a relaxed cooperative patient, anesthesia may not be needed. In other cases, a local perianal anesthetic or procedural sedation can be used. Although the bowel itself has no pain receptors, apprehension and discomfort may lead to spasm of the anal sphincter, making reduction difficult or impossible until relaxation can be achieved.

No randomized trials have compared anesthetic techniques for this specific procedure. Perianal field block has been described as useful for various rectal procedures. Multiple injections of a local anesthetic are made into the ischiorectal fat immediately peripheral to the external sphincter, with good anesthesia occurring in just a few minutes. [2]  The injections themselves are painful.

Positioning

The patient should be in either the dorsal lithotomy or the knee-chest position. Children may be less anxious if allowed to remain on the lap of a parent.

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Monitoring & Follow-up

Patients should follow up with a primary care provider or a surgeon for further treatment. Patients (or family members) who are capable may be instructed to attempt reduction themselves in case of recurrence.

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