2024 Volume 37 Issue 1 Pages 118-124
Objective : Pelvic organ prolapse (POP) and rectal prolapse (RP) have many causes and pathogenesis in common. Herein, we report 15 patients with coexisting POP and RP who underwent laparoscopic sacrocolpopexy (LSC) and laparoscopic ventral rectopexy (LVR) concomitantly.
Methods: We retrospectively investigated the medical records of 1,530 patients who underwent LSC in our institution between December 2012 and March 2022. We analyzed 15 patients who underwent LSC and LVR concomitantly, 7 of whom had RP recurrence after previous transanal or laparoscopic surgery.
Results: Patients’ mean age was 82 (72-89) years old. The mean total operation time was 233 (126-504) minutes. Fecal incontinence disappeared in 8 out of 13 patients, and constipation improved in 3 out of 13 patients. One patient each experienced perioperative death, rectal suture exposure, and pyogenic spondylitis. RP recurred in 4 patients, 2 of which required further transanal surgery. POP recurrence over Stage II occurred in 3 patients, but there were no complaints of symptoms.
Conclusion: LSC combined with LVR is beneficial to patients with coexisting POP and RP resulting in considerable improvement of QOL. It is advantageous to treat the two diseases together, rather than performing two separate operations. Furthermore, LVR can be effective for patients with recurrent RP after transanal surgery. However, most patients with both POP and RP are in their 70s or 80s. Thus, tolerance for being under general anesthesia for long hours in a head-down tilt position should be carefully considered before planning concomitant LSC and LVR.
