Pregnancy after laparoscopic ventral mesh rectopexy: implications and outcomes

Area of Science:

• Colorectal Surgery
• Pelvic Floor Disorders
• Minimally Invasive Surgery

Background:

• Laparoscopic ventral mesh rectopexy is a treatment for rectal prolapse.
• Surgeons often hesitate to perform this procedure on young women due to concerns about future pregnancies.
• Data on pregnancy outcomes after this surgery is limited.

Purpose of the Study:

• To evaluate pregnancy outcomes in women who underwent laparoscopic ventral mesh rectopexy.
• To assess the impact of pregnancy and delivery on pelvic floor symptoms after the rectopexy procedure.

Main Methods:

• A retrospective review of a prospectively maintained database from a single tertiary referral center.
• Data collected over a 10-year period (2006-2016).
• Pelvic floor symptom scores (Vaizey and Longo) were assessed pre-intervention, post-intervention, and after childbirth.

Main Results:

• Out of 954 rectopexies, 225 patients were women under 45 years old.
• Eight (4%) of these women became pregnant post-rectopexy.
• All deliveries (6 Cesarean sections, 2 vaginal deliveries) were successful with no mesh-related complications reported. Post-delivery pelvic floor symptoms showed no significant change compared to post-rectopexy scores.

Conclusions:

• This study is the first to report on delivery outcomes after laparoscopic ventral mesh rectopexy.
• Safe delivery, either via Cesarean section or vaginal birth, is possible.
• Laparoscopic ventral mesh rectopexy does not adversely affect pelvic floor function or quality of life in women who subsequently become pregnant.