Preliminary Report From the Pelvic Floor Disorders Consortium: Large-Scale Data Collection Through Quality...

Area of Science:

• Colorectal Surgery
• Pelvic Floor Disorders
• Surgical Quality Improvement

Background:

• Rectal prolapse management is evolving, but clinical trials lack conclusive evidence on operative approaches.
• Numerous studies have not yielded definitive conclusions on the best surgical techniques.

Purpose of the Study:

• To report preliminary data from a large-scale quality improvement initiative focused on functional outcomes in rectal prolapse repair.
• To measure and improve functional results for patients undergoing rectal prolapse surgery.

Main Methods:

• Retrospective analysis of prospectively collected surgical quality improvement data.
• Inclusion of 181 consecutive patients undergoing external rectal prolapse repair across 14 tertiary centers (2017-2019).
• Preoperative and 3-month postoperative assessment using Wexner incontinence and Altomare obstructed defecation scores.

Main Results:

• Abdominal surgery (n=112) included suture rectopexy and ventral rectopexy; perineal approaches (n=68) were used in older patients with more comorbidities.
• Both abdominal and perineal repairs showed similar functional improvements (Wexner, Altomare scores).
• Ventral mesh rectopexy demonstrated a greater reduction in pad usage compared to posterior suture rectopexy.

Conclusions:

• All patients experienced functional improvements after rectal prolapse surgery.
• Larger patient cohorts are required to establish the superiority of specific surgical procedures.
• Quality improvement methods offer a practical approach to data acquisition and analysis for pelvic floor disorders.