Surgical management of combined rectal and genital prolapse in young patients: transabdominal approach.
BACKGROUND
The aim of this study was to determine the anatomical and functional outcomes of the simultaneous treatment of combined rectal and genital prolapse in young patients.


METHODS
Between March 2001 and June 2002, eight female patients with symptomatic rectal and genital prolapse were enrolled in this study. The median age at the time of presentation was 44 years (range 34-53). All patients underwent simultaneous transabdominal treatment of their combined prolapse. Genital prolapse was treated by colpohysteropexy. Rectal prolapse was treated by mesh rectopexy or sutured rectopexy associated with sigmoid resection. The end evaluation to assess long-term results was performed after a median duration of follow-up of 17 months (range 10-24). Patients were asked about current problems with constipation, use of laxatives, incontinence and recurrence.


RESULTS
The postoperative course was uneventful in 7 out of 8 cases. None of the patients had recurrence. Three patients out of 6 remained constipated postoperatively. One patient had a new onset of constipation postoperatively. None of the patients became faecally incontinent. Seven patients (87%) stated that they had improved overall after surgery.


CONCLUSIONS
Combined rectal and genital prolapse in young women can be safely treated simultaneously using an abdominal approach. The genital prolapse should be treated by colpohysteropexy. The rectal prolapse should be treated by mesh rectopexy in patients who are not constipated, and by sutured rectopexy plus sigmoid resection in patients who are constipated preoperatively.
Ayav
A
A
Department of Digestive Surgery, University Hospital Nancy-Brabois, 54511 Vandoeuvre les Nancy, France. a.ayav@chu-nancy.fr
Bresler
L
L
Brunaud
L
L
Zarnegar
R
R
Boissel
P
P
D000005:Abdomen; D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*