Muhammad Amjad Chaudhry, Anwar Khan, Parveez Khan.
Rectal Prolapse in Children: A Comparative Study of 5% Phenol with Almond Oil Versus 15% Hypertonic Saline for its Treatment.
Ann Pak Inst Med Sci Jan ;12(4):262-6.

Objectives: The objective of the study was to compare the efficacy of 5% Phenol in almond oil with 15% hypertonic saline in the treatment of rectal prolapse. Methodology: It was a randomized control trial that was conducted at Department of Pediatric Surgery, Children Hospital, PIMS, Islamabad. Children were subjected to injection sclerotharpy with either 5% Phenol in almond oil (50 patients) or 15% hypertonic saline solution (50 patients). The children were followed for 3 months for recurrence, fecal incontinence or anal stenosis. Results: The study included 100 children with grade I or grade II rectal prolapse. The mean age was 6.61 (±2.75) years. The study included 55% (n=55) males and 45% (n=45) females. The difference in age and gender distribution between the two groups was not significantly different, (p= 0.971) for age and (p= 0.159) for gender difference respectively. A total of 36% (n=36) patients had grade I and 64% (n=64) had grade II prolapse. The two groups were not significantly different with respect to grade of rectal prolapse (p= 0.677). The presenting features were mass coming out of anal canal in 100%, a history of bleeding per rectum in 22% (n=22) and pallor on clinical examination in 26% (n=26). In the 5% phenol group, 24% (n=12) and in hypertonic saline group 46% (n=23) had recurrence of rectal prolapse. This difference was statistically significant (p= 0.021). In the 5% phenol group 2% (n=2) and in hypertonic saline group 2% (n=1) had postoperative fecal incontinence. This difference was not statistically significant (p= 0.558). In the 5% phenol group 8% (n=4) has anal stenosis and in hypertonic saline group 2% (n=1) had anal stenosis. This difference was not statistically significant (p= 0.169). Conclusions: 5% phenol in almond oil was more effective than 15% hypertonic saline in treatment of rectal prolapsed in terms of significantly lower recurrence rate and statistically comparable rate of complications including fecal incontinence and anal stenosis.

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