Safety and efficacy of laparoscopic ventral mesh rectopexy for complex rectocele.
OBJECTIVE
Laparoscopic ventral mesh rectopexy, previously described for external rectal prolapse, was evaluated for symptomatic complex rectocoele.


METHODS
From January 2004 to December 2008, 84 (50.9%) patients (mean age 64 ± 5 years) underwent laparoscopic ventral mesh rectopexy for symptomatic complex rectocoele, confirmed preoperatively on dynamic defaecography, with 26 (31%) patients having a concurrent cystocoele. The operative technique was standardized, and those with cystocoele underwent bladder mesh suspension during the same procedure. Prospectively collected data were analysed for preoperative symptoms, operative and functional results [constipation, faecal incontinence (FI), dyspareunia and satisfaction score].


RESULTS
The conversion rate was 3.6% and perioperative morbidity 4.8% with no mortality. At a median follow up of 29 (4-59) months, there was a significant decrease in vaginal discomfort (86-20%) and obstructed defaecation symptoms (83-46%), P < 0.001. There was no significant change in FI (20-16%), no worsening of preoperative symptoms or new complaints of constipation, dyspareunia or FI. Overall, 88% of patients reported an improvement in overall well-being.


CONCLUSIONS
Laparoscopic ventral mesh rectopexy is a safe and effective method for treating symptomatic complex rectocoele.
Wong
M
M
Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes Hotel Dieu, Nantes, France.
Meurette
G
G
Abet
E
E
Podevin
J
J
Lehur
P A
PA
D000368:Aged; D003248:Constipation / Q000209:etiology; D052858:Cystocele / Q000150:complications / Q000601:surgery; D003672:Defecation; D019841:Defecography; D004414:Dyspareunia / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006547:Hernia / Q000150:complications; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D017060:Patient Satisfaction; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery; D020047:Rectocele / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013526:Surgical Mesh / Q000009:adverse effects