pelviperineology. 2022; 41(1): 46-53 | DOI: 10.34057/PPj.2022.41.01.2021-10-1

Use of colpocleisis associated to rectopexy as an approach to concomitant apical prolapse and external rectal prolapse

Ana LEWIN¹, Ileana SÄNGER¹, Fabio LEIRO², Romina BIANCHI³, Martina SANTILLAN ITURRES^4
1Department of Female Pelvic Medicine and Reconstructive Surgery, Hospital General de Agudos J.M. Penna, Buenos Aires, Argentina, ²Departament of Surgery, Hospital General de Agudos J. M. Penna, Buenos Aires, Argentina, ³Section of Coloproctology, Hospital General de Agudos J.M. Penna, Buenos Aires, Argentina, ⁴Faculty of Medicine, Buenos Aires University, Buenos Aires, Argentina

Objectives: The primary objective is to describe the long-term anatomic and subjective outcomes in women undergoing obliterative surgery for the management of pelvic organ prolapse with rectopexy. The secondary objective is to describe the adverse perioperative events. Methods: This is a retrospective cohort of women who underwent Le Fort colpocleisis with laparoscopic Protack rectopexy at a tertiary care center between 2013 and 2021. A composite outcome for recurrent pelvic organ prolapse and rectal prolapse was defined as subjective failure (vaginal or rectal prolapse symptoms), objective failure (prolapse to or beyond the hymen or full thickness rectal prolapse), or any retreatment for prolapse. Patient’s subjective outcomes was recorded at baseline and in the last follow-up visit. Adverse perioperative events were defined a priori and collected up to 6 weeks after surgery. Results: None of the patients presented recurrence of pelvic organ prolapse and only one presented a symptomatic recurrence of rectal prolapse, not externalized over the anal margin therefore did not require surgical treatment. All the patients improved their scores in the Pelvic Floor Impact Questionnaire – Short Form 20 (PFIQ-20) survey, finding occasional worsening of the symptoms associated with urinary incontinence and voiding urgency. Only one patient presented a minor postoperative complication, which did not require hospital admission. Conclusion: Although good results were achieved with a low rate of recurrence, additional studies with larger number of patients are needed to confirm this findings.

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Cite This Article

LEWIN A, SÄNGER I, LEIRO F, BIANCHI R, SANTILLAN ITURRES M. Use of colpocleisis associated to rectopexy as an approach to concomitant apical prolapse and external rectal prolapse. 2022; 41(1): 46-53

Corresponding Author: LEWIN A.

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