title: Short-term results for laparoscopic ventral rectopexy using biological mesh for pelvic organ prolapse.
abstract: OBJECTIVE
  There is growing evidence that laparoscopic ventral rectopexy (LVR) is an effective treatment for pelvic organ prolapse and obstructive defaecation caused by rectocele. LVR is usually performed using synthetic mesh despite concerns about mesh erosion. We present our experience of using a porcine dermal collagen mesh (Permacol™) for LVR, which is the largest such case series to date.
  
  
  METHODS
  Data on 65 patients were collected prospectively from May 2008 to October 2010. Outcome measures were complications, recurrence, length of hospital stay, patient satisfaction, Wexner constipation score and Wexner incontinence score. Preoperative and postoperative scores were compared using the two-tailed Wilcoxon signed rank test. P<0.05 was considered statistically significant.
  
  
  RESULTS
  There were statistically significant improvements in the Wexner constipation scores at 6 months and 1 year (both P<0.0001) and in faecal incontinence scores at 6 months (P<0.0001) and 1year (P=0.0002). There were no cases of mesh erosion or mesh-related infection in our series. Recurrence of symptoms occurred in two patients (3.1%). Symptoms were rated as much better or better by 93% of patients at 6months and this was sustained at 1year (96%).
  
  
  CONCLUSIONS
  In the short term, LVR using biological mesh is safe and as effective as synthetic mesh, with high patient satisfaction. Constipation and faecal incontinence scores were both improved.
authors.affiliation: Department of Colorectal Surgery, Queen Elizabeth Hospital, Gateshead, UK.
authors.forename: S
authors.initials: S
authors.lastname: Wahed
authors.forename: M
authors.initials: M
authors.lastname: Ahmad
authors.forename: K
authors.initials: K
authors.lastname: Mohiuddin
authors.forename: M
authors.initials: M
authors.lastname: Katory
authors.forename: M
authors.initials: M
authors.lastname: Mercer-Jones
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen; D003248:Constipation / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: C422414:Permacol; D003094:Collagen