Absorbable mesh in the treatment of rectal prolapse

Transabdominal rectopexy is a widely used method with excellent results in the treatment of rectal prolapse; a variety of absorbable and non-absorbable materials has been described in the literature. In the Department of Surgery in the University of Munster we have been using absorbable mesh (Vicryl/Dexon) routinely to perform rectopexy. These materials are practically identical in their mode of degradation. Both are absorbed completely, releasing glycolic acid which is believed to be bacteriostatic. In this series of 62 cases absorbable mesh was used to fix the mobilised rectum to the sacrum. The operations were performed using one-dose antibiotic prophylaxis. There were no deaths. Two recurrences developed within two weeks of operation, one complete and one incomplete. Both cases, however, had been operated upon by inexperienced surgeons. Two further recurrences occurred after 36 and 45 months; thus the overall rate of recurrence was 6.4%. In no case was there abdominal or pelvic infection. We believe that absorbable mesh is a suitable material for performing rectopexy, reducing the rate of abdominal and particularly pelvic infection without increasing recurrence rate.