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International Journal of Colorectal Disease

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01-05-2016 | Original Article

Laparoscopic ventral mesh rectopexy in complex pelvic floor disorder

Authors: K Horisberger, A Rickert, S Templin, S Post, P Kienle

Published in: International Journal of Colorectal Disease | Issue 5/2016

Abstract

Aim

For the treatment of complex pelvic organ prolapse, many different surgical procedures are described without any comparative studies available. Laparoscopic ventral mesh rectopexy after D’Hoore is one of the methods, which is publicized to treat patients with symptomatic rectocele, enterocele and rectal prolapse.

Method

All patients who received ventral mesh rectopexy since 07/10 for symptomatic rectocele, enterocele and possible rectal prolapse I ° or II ° in terms of a complex pelvic floor disorder were included in this follow-up study. The Wexner score for incontinence was recorded (range 0–20), the constipation score of Herold (r6-30) was evaluated as well as supplementary questions compiled by D’Hoore concerning outlet symptoms (r0-20). In addition, the quality of life (SF-12) was requested.

Results

Thirty-one women were operated in the period, and 27 were eligible to be included in the present study. Median follow-up was 22 months (2–39). The preoperative Wexner score was in median 8 (0–20), going down to 6 (0–20) without significance (p = 0.735). The constipation score decreased significantly from median 14 (9–21) to 11 (6–25) (p = 0.007). The median score after D’Hoore was preoperatively 8 (4–16) and 4.5 (0–17) postoperatively (p = 0.004). The SF-12 values were preoperatively significantly reduced compared to the normal population; postoperatively, they equalized.

Conclusion

Two years after laparoscopic ventral mesh rectopexy, constipation and quality of life improve significantly in patients with complex pelvic organ prolapse. The grade of incontinence remains essentially the same, but was not the dominant clinical problem in the treated patients of our study.

Statement

The improvement in constipation and quality of life after laparoscopic ventral mesh rectopexy for obstructive defecation is encouraging. However, the impact on sexual life differs; some patients improve but a relevant number reports a change for the worse.

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Title: Laparoscopic ventral mesh rectopexy in complex pelvic floor disorder
Authors: K Horisberger
A Rickert
S Templin
S Post
P Kienle
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 5/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2545-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic ventral mesh rectopexy in complex pelvic floor disorder

Abstract

Aim

Method

Results

Conclusion

Statement

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Aim

Method

Results

Conclusion

Statement

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