Combined rectopexy and sacrocolpopexy for multi compartment pelvic floor prolapse: better outcomes?_On Demand-Presentation Slides

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This document discusses the use of combined rectopexy and sacrocolpopexy for multi-compartment pelvic floor prolapse and its potential for better outcomes. The key concept is to restore normal anatomy and improve function and quality of life. The document highlights the PROSPER study from the UK, which showed high recurrence rates with perineal procedures and sutured posterior rectopexy. It also mentions that posterior dissection is associated with increased rates of constipation. <br /><br />The document discusses the benefits of ventral rectopexy, including correcting the middle compartment, preserving autonomic nerves, and using mesh to improve constipation. It also mentions that rectal intussusception doesn't lead to prolapse and can be effectively treated with ventral rectopexy. Indications for combined rectopexy and sacrocolpopexy are listed as full-thickness rectal prolapse and symptomatic rectal intussusception. <br /><br />The document provides a list of contraindications for the procedure, such as pregnancy, severe endometriosis, and a history of pelvic radiation. It also mentions synthetic and biologic mesh options, complications that can arise from the procedure, and the potential impact on sexual function and urinary incontinence.<br /><br />The document presents various studies and experiences that support the use of combined rectopexy and sacrocolpopexy. These include studies showing improved constipation and quality of life outcomes, reduced recurrence rates, and similar outcomes between laparoscopic and robotic approaches. The document also emphasizes the importance of adequately trained surgeons and multidisciplinary teams, as well as patient selection and follow-up.<br /><br />Overall, the document provides a comprehensive overview of combined rectopexy and sacrocolpopexy for multi-compartment pelvic floor prolapse and highlights its potential for better outcomes in terms of anatomical restoration and improved function.

Keywords

combined rectopexy

sacrocolpopexy

multi-compartment pelvic floor prolapse

outcomes

normal anatomy

function

quality of life

recurrence rates

constipation

mesh