Stoma Prolapse

Stoma prolapse after formation of an ileostomy or colostomy is a late complication. Prolapse is less common than parastomal hernia. This article reviews the incidence of prolapse, technical factors related to the construction of the stoma that may influence the incidence, and different options for repair. Stoma prolapse affects 2%-47% of individuals with ostomies. Transverse loop colostomy has the highest rate of stoma prolapse, especially because of the large redundant distal loop. Loop ileostomies were thought to have a higher prevalence rate in the past, but recent literature shows only a 2% prolapse rate for ileostomy as opposed to 47% for loop colostomy. The role of extraperitoneal stoma construction is uncertain. Fascial fixation and size of the fascial defect have not been proven to affect the incidence of prolapse. Local care of stoma prolapse is possible, especially if stoma is not incarcerated; however, reversal of stoma is preferable if possible. The options of surgical repair include reversal, resection, revision, and relocation.