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International Journal of Colorectal Disease

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01-10-2018 | Original Article

Combined rectopexy and sacrocolpopexy is safe for correction of pelvic organ prolapse

Authors: Cristina B. Geltzeiler, Elisa H. Birnbaum, Matthew L. Silviera, Matthew G. Mutch, Joel Vetter, Paul E. Wise, Steven R. Hunt, Sean C. Glasgow

Published in: International Journal of Colorectal Disease | Issue 10/2018

Abstract

Purpose

Pelvic floor abnormalities often affect multiple organs. The incidence of concomitant uterine/vaginal prolapse with rectal prolapse is at least 38%. For these patients, addition of sacrocolpopexy to rectopexy may be appropriate. Our aim was to determine if addition of sacrocolpopexy to rectopexy increases the procedural morbidity over rectopexy alone.

Methods

We utilized the ACS-NSQIP database to examine female patients who underwent rectopexy from 2005 to 2014. We compared patients who had a combined procedure (sacrocolpopexy and rectopexy) to those who had rectopexy alone. Thirty-day morbidity was compared and a multivariable model constructed to determine predictors of complications.

Results

Three thousand six hundred patients underwent rectopexy; 3394 had rectopexy alone while 206 underwent a combined procedure with the addition of sacrocolpopexy. Use of the combined procedure increased significantly from 2.6 to 7.7%. Overall morbidity did not differ between groups (14.8% rectopexy alone vs. 13.6% combined procedure, p = 0.65). Significant predictors of morbidity included addition of resection to a rectopexy procedure, elevated BMI, smoking, wound class, and ASA class. After controlling for these and other patient factors, the addition of sacrocolpopexy to rectopexy did not increase overall morbidity (OR 1.00, p = 0.98).

Conclusions

There is no difference in operative morbidity when adding sacrocolpopexy to a rectopexy procedure. Despite a modest increase in utilization of combined procedures over time, the overall rate remains low. These findings support the practice of multidisciplinary evaluation of patients presenting with rectal prolapse, with the goal of offering concurrent surgical correction for all compartments affected by pelvic organ prolapse disorders.

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Title: Combined rectopexy and sacrocolpopexy is safe for correction of pelvic organ prolapse
Authors: Cristina B. Geltzeiler
Elisa H. Birnbaum
Matthew L. Silviera
Matthew G. Mutch
Joel Vetter
Paul E. Wise
Steven R. Hunt
Sean C. Glasgow
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 10/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3140-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Combined rectopexy and sacrocolpopexy is safe for correction of pelvic organ prolapse

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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