Combined surgery in pelvic organ prolapse is safe and effective.
OBJECTIVE
In women, rectal prolapse is often accompanied by other signs of generalized pelvic floor weakness including uterine and bladder prolapse. The purpose of this study was to compare whether there are differences in outcomes of rectal prolapse surgery between women having combined pelvic organ prolapse (POP) surgery with a urologist or urogynecologist (CS) vs those having abdominal rectal prolapse surgery alone (RP).


METHODS
Charts were reviewed to collect perioperative data on those having surgery from 1995 to 2001. Phone surveys were conducted to obtain Cleveland Clinic Foundation (CCF) Incontinence score, Knowles-Eccersley-Scott-Symptom (KESS) Constipation Score, Short Form 36 (SF-36) quality of life score and recurrence rate. Appropriate statistical analysis was performed.


RESULTS
Ninety-four operations were performed (23 CS and 71 RP). Forty-six (49%) could be contacted by phone. Mean follow-up was similar in both groups (CS 4.1 vs RP 3.6 years; P = 0.796). There were no significant differences between both groups regarding age, American Society of Anesthesiology classification Score, complications, length of hospital stay, CCF Incontinence score, KESS Constipation Score, SF-36 Score and recurrence rate of rectal prolapse. The operative time (CS 226 vs RP 122 min; P < 0.001) and blood loss (CS 377 vs RP 183 ml; P < 0.001) were significantly increased in the CS group.


CONCLUSIONS
Combined surgery for POP is safe and effective when considering outcomes of rectal prolapse surgery. Therefore surgeons should not hesitate to address all pelvic floor issues during the same operation by working in partnership with the anterior pelvic floor colleagues.
Riansuwan
W
W
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
Hull
T L
TL
Bast
J
J
Hammel
J P
JP
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011788:Quality of Life; D012005:Rectal Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D055502:Secondary Prevention; D013520:Urologic Surgical Procedures / Q000379:methods*