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Related Experiment Videos

Posthysterectomy rectal and vaginal prolapse, a commonly overlooked problem

K Barham1, B T Collopy

  • 1Mercy Hospital for Women, Victoria.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|August 1, 1993
PubMed
Summary

Combined rectal and vaginal prolapse, though common, is often underreported. A new surgical technique, involving a modified Wells rectopexy with vaginal vault anchoring, shows promising early results for pelvic pain and prolapse symptoms.

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Area of Science:

  • Gastroenterology
  • Gynecology
  • Pelvic Floor Surgery

Background:

  • Combined rectal and vaginal prolapse is a complex condition often presenting with pelvic pain, protrusion, and defecatory dysfunction.
  • Previous surgical interventions may not fully address both components, necessitating advanced management strategies.

Purpose of the Study:

  • To describe a further development in the surgical management of combined rectal and vaginal prolapse.
  • To evaluate the initial outcomes of this modified operative procedure in a cohort of 24 patients.

Main Methods:

  • The procedure involves a modified Wells rectopexy with abdominal correction of enterocele and extension of the sling to anchor the vaginal vault.
  • Subsequent vaginal repair is performed if anterior or posterior vaginal prolapse persists.

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  • Key procedural aspects include sepsis avoidance and ureter protection via transvaginal vault endoscopy.

    • Main Results:

    • The study included 24 patients, most with a history of hysterectomy and prior vaginal repairs.
    • Common presenting symptoms included pelvic pain (19 patients), protrusion (14 patients), and defecatory issues/rectal incontinence (9 patients).
    • Early operative morbidity was minimal, with encouraging relief of pelvic symptoms.

    Conclusions:

    • This modified rectopexy offers a potentially effective surgical solution for combined rectal and vaginal prolapse.
    • While early results are promising, long-term evaluation is necessary to confirm sustained efficacy and safety.