title: Pelvic floor-lifting: an interdisciplinary repair of combined rectal and vaginal prolapse-5 years experience.
abstract: OBJECTIVE
  Combined rectal and vaginal prolapse requires a complete repair of the pelvic floor that can only be achieved by an interdisciplinary management. We have, therefore, established a co-operation for preoperative diagnosis, interdisciplinary operations, and postoperative care involving a colorectal surgeon and a gynecologist.
  
  
  METHODS
  Our standardized operation, which we call the pelvic floor-lifting, is a combination of well-established colorectal and gynecological operative steps and the application of surgical principles for hernia repair. A non-absorbable mesh which is used for the Wells rectopexy is used, in addition, to perform a colpopexy and also a repositioning and pre-peritoneal mesh-reinforcement of the pouch of Douglas (Douglas-lifting). The optional final step of the operation is a Burch/Hirsch colposuspension.
  
  
  RESULTS
  We report on the satisfactory colorectal as well as gynecological results of 32 pelvic floor-lifting operations in a 5-year period. In addition, the outcomes of the operations were studied using quality-of-life questionnaires.
  
  
  CONCLUSIONS
  The feasibility of the pelvic floor-lifting operation was demonstrated. The Douglas-lifting, which is the repair of the Douglas hernia according to surgical principles, is the best possible preventive measure against repeat pelvic floor relaxation.
authors.affiliation: Clinic Dr. Guth, Juergensallee 44-48, 22609 Hamburg, Germany. praxis_drpopp@gmx.de
authors.forename: Lothar
authors.initials: L
authors.lastname: Popp
authors.forename: Anke
authors.initials: A
authors.lastname: Augustin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004312:Douglas' Pouch / Q000601:surgery; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000601:surgery*; D011788:Quality of Life; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*