Safety of concurrent transvaginal rectopexy at time of transvaginal apical prolapse repair: A comparative study

Data regarding the safety and efficacy of combining transvaginal native tissue apical prolapse repair and rectopexy procedures is scarce. The aim of this study was to assess the safety and feasability of performing a concurrent rectopexy procedure and transvaginal apical prolapse repair.

This was a retrospective cohort study at a univeristy-affiliated, tertiary medical center. Included were patients who underwent apical prolapse repair, between 2018-2022. The cohort was divided into two groups: 1) Patients who underwent apical prolapse repair with a concomitant rectopexy procedure; 2) Patients who underwent apical prolapse repair alone. The primary outcome of the study was a comparison of complications within the first 30 days after surgery between groups.

A total of 277 patients were included in the final analysis out of which 70 patients had a concomitant rectopexy, as opposed to 207 patients who had an apical repair alone. Mean age was 65.0 ± 11.7, BMI was 27.3 ± 5.3, median parity was 2 (range 0-9) and 72.0 % of patients were Caucasian. No differences in postoperative complications 30 days after surgery were observed between groups. When analyzing unanticipated healthcare encounters, no differences between the groups were noted regarding emergency department and urgent care visits, readmissions, and reoperations. However, the group of patients who underwent rectopexy exhibited a significantly greater occurrence of unanticipated postoperative phone calls (75.7 % vs. 48.8 %, p < 0.001) and clinic visits (40.0 % vs. 15.9 %, p < 0.001) during the 30-day postoperative period.

Concurrent apical prolapse repair and rectopexy is both safe and feasible.