E-Posters-Does Concurrent Posterior Repair for the Asymptomatic Rectocele Reduce Prolapse Recurrence After Sacrocolpopexy?

Does Concurrent Posterior Repair for the Asymptomatic Rectocele Reduce Prolapse Recurrence After Sacrocolpopexy? - Olivia H. Chang, MD, MPH

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A study was conducted to determine if posterior repair is necessary for patients with asymptomatic rectoceles who are undergoing sacrocolpopexy. The study included 344 patients who underwent sacrocolpopexy at a tertiary care center from 2004 to 2014. The patients were divided into two groups: one group had sacrocolpopexy only (SCP), while the other group had sacrocolpopexy with a concurrent posterior repair (SCP+PR). The primary outcome measured was the composite failure rate, which included retreatment by surgery or with a pessary and the subjective bulge symptoms reported by the patients.<br /><br />The results showed that the composite failure rate was 10.2% for both groups, but there was a significant difference between the two groups (p=0.03). The SCP group had a failure rate of 13.5%, while the SCP+PR group had a failure rate of 6.3%. When adjusting for age and prior prolapse surgery, the odds of composite failure were 2.79 times higher in the SCP group compared to the SCP+PR group.<br /><br />Secondary outcomes showed that both groups had low rates of denovo defecatory dysfunction following surgery, with rates of 6.0% in the SCP group and 7.6% in the SCP+PR group. The rates of dyspareunia were also low, with 1.9% in the SCP+PR group and 0.5% in the SCP group, although the difference was not statistically significant.<br /><br />In conclusion, the study found that a concurrent posterior repair at the time of sacrocolpopexy reduces the odds of composite failure in patients with asymptomatic rectoceles, without increasing the rates of dyspareunia or denovo defecatory dysfunction. These findings suggest that posterior repair may be necessary for optimal outcomes in these patients.

Keywords

posterior repair

asymptomatic rectoceles

sacrocolpopexy

composite failure rate

retreatment

pessary

subjective bulge symptoms

denovo defecatory dysfunction

dyspareunia

optimal outcomes