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Updated: May 6, 2026
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Laparoscopic ventral rectopexy for fecal incontinence associated with high-grade internal rectal prolapse
Martijn P Gosselink1, S Adusumilli, Kim J Gorissen
1Oxford Pelvic Floor Centre, Department of Colorectal Surgery, Churchill Hospital, Oxford, United Kingdom.
Background:
The role of internal rectal prolapse in the origin of fecal incontinence remains to be defined. In our institution, laparoscopic ventral rectopexy is offered to patients with high-grade internal prolapse and fecal incontinence.
Objective:
The present study was designed to evaluate the functional outcome after laparoscopic ventral rectopexy in patients with fecal incontinence associated with high-grade internal rectal prolapse.
Design:
This study was designed as a prospective observational study.
Settings:
The study took place in a university hospital.
Patients:
Between 2009 and 2011, 72 patients with fecal incontinence not responding to maximum medical treatment (including biofeedback) were included. All patients had a grade III or grade IV rectal prolapse.
Intervention:
Laparoscopic ventral rectopexy was performed.
Main Outcome Measures:
Preoperative endoanal ultrasonography and anorectal manometry were performed. Fecal continence was evaluated by using the Rockwood Fecal Incontinence Severity Index score before and 1 year after surgery.
Results:
The median fecal incontinence severity index score 1 year after surgery was lower than the median score before surgery (15 versus 31; p < 0.01), representing an improvement in fecal continence.
Limitations:
This was a preliminary observational study with no control group, no postoperative proctography, and no postoperative anal physiology.
Conclusion:
Laparoscopic ventral rectopexy can improve symptoms of fecal incontinence in patients with a high-grade internal rectal prolapse. Internal rectal prolapse contributes to the multifactorial origin of fecal incontinence.
