Short-term results for laparoscopic ventral rectopexy using biological mesh for pelvic organ prolapse

There is growing evidence that laparoscopic ventral rectopexy (LVR) is an effective treatment for pelvic organ prolapse and obstructive defaecation caused by rectocele. LVR is usually performed using synthetic mesh despite concerns about mesh erosion. We present our experience of using a porcine dermal collagen mesh (Permacol™) for LVR, which is the largest such case series to date.

Data on 65 patients were collected prospectively from May 2008 to October 2010. Outcome measures were complications, recurrence, length of hospital stay, patient satisfaction, Wexner constipation score and Wexner incontinence score. Preoperative and postoperative scores were compared using the two-tailed Wilcoxon signed rank test. P<0.05 was considered statistically significant.

There were statistically significant improvements in the Wexner constipation scores at 6 months and 1 year (both P<0.0001) and in faecal incontinence scores at 6 months (P<0.0001) and 1year (P=0.0002). There were no cases of mesh erosion or mesh-related infection in our series. Recurrence of symptoms occurred in two patients (3.1%). Symptoms were rated as much better or better by 93% of patients at 6months and this was sustained at 1year (96%).

In the short term, LVR using biological mesh is safe and as effective as synthetic mesh, with high patient satisfaction. Constipation and faecal incontinence scores were both improved.