Feasibility and functional outcome of laparoscopic sacrocolporectopexy for combined vaginal and rectal prolapse.

Abstract

Prolapse of multiple pelvic organs causes a variety of symptoms that impair a patient's quality of life. A laparoscopic procedure is described that uses a mesh fixation of the mid-compartment vagina to the sacrum with additional rectopexy to correct both the anatomical deformities and the dysfunction of the posterior compartment. Patients with significant rectal and vaginal prolapse with or without rectocele were recruited. A thorough preoperative physiological assessment of each of the compartments of the pelvic floor was carried out. Patients also completed the Pelvic Floor Distress Inventory before and six months after surgery. Ten patients underwent the procedure of laparoscopic sacrocolporectopexy (median age 47 years, interquartile range 43-53). No mortality or morbidity occurred. Median global distress inventory scores were significantly lower postoperatively (8.3, interquartile range 0-20.8 vs. 37.5, interquartile range 16.6-60.4) P = 0.012. All three median subscales were also significantly lower postoperatively. The procedure corrected associated rectoceles and descent of the perineum on straining. The described laparoscopic procedure of mesh sacrocolpopexy with rectopexy was safe and feasible and conferred good symptomatic improvement in pelvic floor dysfunction.