Laparoscopic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse

Giovanni Scambia, Carlo Ratto, Giuseppe Campagna, Giovanni Panico, Angelo Parello, Valeria Gallucci, Alfredo Ercoli, A. Ercoli

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Pelvic organ prolapse (POP) is a dynamic disorder that affects the entire pelvic diaphragm. POP may often involve multiple organs. Abdominal sacrocolpopexy is considered the gold standard to treat female anterior and apical prolapse. Abdominal ventral mesh rectopexy has gained increasing acceptance as an effective treatment for rectal prolapse. The aim of the present study was to assess the safety, feasibility and 1-year outcomes of laparoscopic sacrocolpopexy plus ventral rectopexy as a combined treatment of multicompartment POP. Methods: All female patients at our institution with anterior and apical prolapse with symptoms of obstructed defecation were examined by an urogynecologist and a colorectal surgeon, and were judged suitable for the study. Patients with Pelvic Organ Prolapse Quantification (POP-Q) system stage III and IV and concomitant rectal prolapse were treated by laparoscopic sacrocolpopexy plus ventral rectopexy. After surgery, 1- and 12-month follow-up was performed and the data were retrospectively analyzed. Patients’ symptoms were evaluated using the Female Sexual Distress Scale (FSDS), Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12), and Wexner–Agachan constipation score. Results: A total of 98 patients underwent surgery. No intraoperative or postoperative morbidity occurred. At the time of follow-up, all women expressed great satisfaction with the surgical treatment: all the patients had at most POP-Q Stage 1 and 78.8% had a Patient Global Impression of Improvement (PGI-I) score < 3. Significant improvement of symptoms related to POP and to obstructed defecation syndrome, as shown by the FSDS, PISQ-12, and Wexner–Agachan constipation score, was observed in all patients at follow-up Conclusions: Laparoscopic sacrocolpopexy with ventral rectopexy is a feasible and safe procedure for the combined surgical management of anterior, apical, and posterior prolapse, and provides excellent objective and subjective outcomes.
Original languageEnglish
Pages (from-to)573-584
Number of pages12
JournalTechniques in Coloproctology
Volume24
DOIs
Publication statusPublished - 2020

Keywords

  • Laparoscopy
  • Rectal Prolapse
  • Pelvic organ prolapse
  • Rectal prolapse
  • Sacrocolpopexy
  • Ventral rectopexy
  • Female
  • Humans
  • Retrospective Studies
  • Surgical Mesh
  • Treatment Outcome
  • Digestive System Surgical Procedures
  • Pelvic Organ Prolapse
  • Obstructed defecation

Fingerprint

Dive into the research topics of 'Laparoscopic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse'. Together they form a unique fingerprint.

Cite this