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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse

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Sexual function and laparoscopic ventral rectopexy for complex rectocoele.

E Abet¹, P A Lehur, M Wong

¹Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, University Hospital of Nantes - Hôtel Dieu, Nantes, France.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|June 2, 2012

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Laparoscopic ventral rectopexy (LVR) improves sexual function and reduces painful intercourse in women with rectocele. This surgery offers benefits beyond anatomical restoration and bowel function improvement.

Area of Science:

Urogynecology
Pelvic Floor Disorders
Minimally Invasive Surgery

Background:

Posterior pelvic floor prolapse, specifically rectocele, affects female anatomy and rectal emptying.
Sexual function in patients undergoing Laparoscopic Ventral Rectopexy (LVR) for rectocele remains understudied.
LVR is a recognized treatment for rectocele, restoring anatomy and improving bowel function.

Purpose of the Study:

To evaluate the impact of Laparoscopic Ventral Rectopexy (LVR) on sexual activity and comfort in women with complex rectocele.
To assess the postoperative sexual function using the Brief Index Sexual Functioning for Women (BISF-W) questionnaire.
To determine patient acceptance of discussing sexual function in the context of pelvic floor disorder treatment.

Main Methods:

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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse

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Prospective assessment of 41 patients undergoing LVR (laparoscopic or robotic) for symptomatic complex rectocele.

Initial screening for sexual activity using a simplified questionnaire, followed by the BISF-W questionnaire postoperatively.

Comparison of postoperative sexual outcomes with French general population data.

Main Results:

Of 38 patients with successful LVR, 47.4% were sexually active postoperatively (compared to 57.9% preoperatively).
No new cases of painful intercourse (dyspareunia) were reported; overall dyspareunia significantly decreased (13 to 6 patients).
Sexual comfort in LVR patients was comparable to the general population, with 86% responding to the BISF-W questionnaire.

Conclusions:

Sexual function assessment is well-accepted by patients with pelvic floor disorders.
Laparoscopic Ventral Rectopexy (LVR) not only restores anatomy and bowel function but also enhances sexual function and reduces dyspareunia.
LVR is a beneficial treatment option for women with complex rectocele, positively impacting their sexual well-being.