Minimally invasive ventral rectopexy for vaginal enterocele Treatment: A multicentric study

The primary aim of this study is to assess the anatomical and functional outcomes of minimally invasive ventral rectopexy (VRP) in patients diagnosed with enterocele.

All women with symptomatic vaginal enterocele with or without anorectal symptoms and who underwent minimally invasive VRP were retrospectively included. Anatomical and functional outcomes, including Wexner constipation and incontinence scores, were evaluated at baseline and at follow-up. Primary outcome was to evaluate anatomical posterior compartment outcomes at ≥ 6 months of follow-up. Secondary outcome included functional results and peri- and postoperative complications.

Seventy women were included. Clinically significant rectal prolapse (RP) was present in 31.4 % (22/70) of the study population. Concomitant anterior sacrocolpopexy (SCP) in 65.7 % of women (46/70). After a mean follow-up of 18 months, posterior compartment relapse occurred in 1.4 % (1/70). Functional outcomes improved significantly, with mean Wexner constipation scores decreasing from 17.5 ± 5.9 to 2.2 ± 2.9 (p < 0.001) and incontinence scores from 10.6 ± 4.0 to 1.3 ± 2.2 (p < 0.001). Most anorectal symptoms improved significantly. Anatomical and functional outcomes did not significantly differ between women with and without RP. No reintervention for prolapse recurrence were required. One patient (1.5 %) underwent mesh removal due to infection.

Minimally invasive VRP appears to be a safe and effective surgical option for enterocele, providing durable anatomical and functional restoration with a low complication rate. It may be particularly valuable in the treatment of complex posterior compartment prolapse, frequently associated with multicompartmental defects.