[Ventral rectal sacropexy (colpo-perineal) in the treatment of rectal and rectogenital prolapse].
BACKGROUND
Ventral sacral-rectopexy with mesh corrects rectal prolapse and minimises rectal dissection. Subsequent colpopexy corrects apical and posterior prolapses of the vagina. The combination of both procedures can lead to the simultaneous correction of pelvic organ prolapses (POP).


OBJECTIVE
To present the results of a patient series with several types of POP treated using the same approach and operation.


METHODS
A total of 57 patients diagnosed with any type of POP were operated on between January 2005 and August 2008 using ventral rectal-colpo-sacropexy, who were grouped into three types: A, total rectal prolapse isolated or combined with a hysterocele or colpocele (11 patients); B, rectoenterocele with internal rectal invagination and/or descending perineum (4 patients); and C, middle and posterior genital compartment prolapse (42 patients). The laparoscopic approach was used in the 15 patients of groups A and B and 11 from group C. A biological mesh was used in 41 patients and a macroporous synthetic one in the rest.


RESULTS
The mean age of the patients in the series was 66 (19-81) years, with 55 females and 2 males. The median follow up was 25 (4-48) months. There were no major post-surgical complications. A recurrence of prolapse was recorded in one patient in group A (1/11); the 7 patients who suffered from incontinence improved after the surgery, no case of de novo constipation being recorded and an improvement in 8 of the 9 patients from groups A and B with obstructive defaecation. There were 9 (21%) recurrences detected in group C, but only 4 (9%) required reintervention. In all the recurrences a biological mesh had been used.


CONCLUSIONS
Laparoscopic ventral rectal-colpo-pexy is an effective technique to correct POP. Although safe and innocuous, the results with biological meshes did not last as long.
Enríquez-Navascués
José M
JM
Servicio de Cirugía General y Digestiva, Sección de Cirugía Colorrectal, Unidad de Suelo Pélvico, Hospital Donostia, Donostia, Spain.
Elósegui
José L
JL
Apeztegui
Francisco J
FJ
Placer
Carlos
C
Borda
Nerea
N
Irazusta
Martín
M
Múgica
José A
JA
Murgoitio
Javier
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012005:Rectal Prolapse / Q000601:surgery*; D011795:Surveys and Questionnaires; D014596:Uterine Prolapse / Q000601:surgery*; D055815:Young Adult