Co-existent Uterovaginal and Rectal Prolapse Management: A Case Series

Area of Science:

• Urogynecology and colorectal surgery
• Pelvic floor reconstructive surgery

Background:

• Simultaneous uterovaginal and rectal prolapse (dual prolapse) is an uncommon condition.
• Management typically involves complex surgical approaches, including abdominal and laparoscopic techniques.
• This case series explores the efficacy of a perineal approach for concurrent dual prolapse repair.

Observation:

• Four patients with varying degrees of uterovaginal and rectal prolapse were treated.
• All patients had completed childbearing and consented to hysterectomy.
• Surgical procedures included vaginal hysterectomy, pelvic floor repair, Delorme procedure, anterior colporrhaphy, posterior colpoperineorrhaphy, and levatorplasty.

Findings:

• A perineal approach, combining vaginal hysterectomy with either the Delorme procedure or posterior colpoperineorrhaphy, successfully treated dual prolapse.
• Six-month follow-up showed complete resolution of symptoms and absence of prolapse on examination.
• All surgeries were performed under spinal anesthesia, a suitable option for high-risk patients.

Implications:

• The perineal approach offers a viable and effective strategy for simultaneous repair of uterovaginal and rectal prolapse.
• Spinal anesthesia makes this technique accessible for patients who may not tolerate general anesthesia.
• This approach simplifies concurrent management, potentially reducing morbidity and improving patient outcomes.