title: Laparoscopic repair of recurrent lateral enterocele and rectocele.
abstract: It is difficult to determine what types of procedures should be attempted in patients who have recurrent prolapse. We present a case of recurrent lateral enterocele and rectocele after the patient had undergone multiple surgeries for pelvic organ prolapse (POP), including a vaginal hysterectomy, bladder-neck suspension, anterior colporrhaphy, site-specific rectocele repair, apical mesh implant, iliococcygeus vault suspension, and transobturator suburethral sling procedure. With recurrence, the patient underwent robot-assisted laparoscopic sacral colpopexy, tension-free vaginal tape transobturator sling insertion, rectocele repair, and perineorrhaphy with cystoscopy. She then presented with defecatory outlet obstruction and constipation and subsequently was treated with a stapled transanal rectal resection. The patient returned with continued defecatory dysfunction and a recurrent lateral enterocele and rectocele. The recurrence was treated laparoscopically using a lightweight polypropylene mesh. The postoperative period was uneventful. Two years later, the patient reported decreased defecatory symptoms and no further symptomatic prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Surgery, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA, ersolomonmd@gmail.com.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Solomon
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Muffly
authors.forename: Tracy
authors.initials: T
authors.lastname: Hull
authors.forename: Marie Fidela R
authors.initials: MF
authors.lastname: Paraiso
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D020047:Rectocele / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation