Does Ventral Rectopexy Improve Pelvic Floor Function in the Long Term?

Area of Science:

• Colorectal surgery
• Pelvic floor dysfunction treatment
• Surgical outcomes research

Background:

• Laparoscopic ventral mesh rectopexy (LVMR) is a surgical option for rectal prolapse.
• Long-term functional outcomes, sequelae, and predictors of success require further investigation.

Purpose of the Study:

• To evaluate long-term functional outcomes after LVMR in patients with external or internal rectal prolapse.
• To identify patient-related factors and operative details influencing patient-reported outcomes.

Main Methods:

• Retrospective review and cross-sectional questionnaire study.
• Data from prospectively collected registries in Finnish university and central hospitals.
• 508 consecutive patients treated for rectal prolapse between 2005 and 2013.

Main Results:

• Median follow-up of 44 months in 330 respondents (70.7% response rate).
• Significant symptom relief reported by 76% of patients; higher in external rectal prolapse (86%) vs. internal rectal prolapse (68%).
• Complication rate was 11.4%, with a 7.1% recurrence rate for rectal prolapse.

Conclusions:

• LVMR is effective for posterior pelvic floor dysfunction with low complication and acceptable recurrence rates.
• External rectal prolapse patients experience greater benefit from LVMR compared to internal rectal prolapse patients.
• Study limitations include lack of preoperative data and suboptimal response rate.