E-Posters-Surgical Approach, Complications and Recurrence after Combined Rectal Prolapse and Pelvic Organ Prolapse Surgery at a Single Tertiary Care Center from 2008 to 2019

Surgical Approach, Complications and Recurrence after Combined Rectal Prolapse and Pelvic Organ Prolapse Surgery at a Single Tertiary Care Center from 2008 to 2019 - Shannon L. Wallace, MD

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A retrospective review of female patients who underwent combined rectal prolapse (RP) and pelvic organ prolapse (POP) surgery was conducted at a single tertiary care center from 2008 to 2019. The study aimed to investigate the surgical approach, complications, and recurrence rates in these patients. The surgical treatment for concurrent RP and POP can be performed either through the perineal or abdominal route in a single surgery, with low morbidity and good long-term improvement in symptoms reported. The study included patients who underwent surgery performed by pelvic reconstructive surgeons and colorectal surgeons.<br /><br />The need for subsequent surgery for recurrent RP or POP after the combined procedure was similar to previously reported rates for recurrence in RP or POP surgery alone. The rate of <30 day complications after the combined surgery was similar to reported rates in the literature, but major complications were rare. The study found that the number of <30 day complications was higher in patients who underwent abdominal prolapse repair via laparotomy compared to minimally invasive procedures. Patient characteristics were similar, although a higher proportion of patients undergoing perineal RP and transvaginal POP repair were older, had higher ASA scores, and had pulmonary disease.<br /><br />Overall, the need for subsequent RP surgery for recurrent RP was 16%, and the need for subsequent vaginal POP surgery for recurrent POP was 4.8%. The need for subsequent RP surgery and vaginal POP surgery was highest in patients who underwent abdominal RP and transvaginal POP surgery.<br /><br />In conclusion, the study provides evidence that combined RP and POP surgery can achieve favorable outcomes with low morbidity and a similar recurrence rate to RP or POP surgery alone. The choice of surgical approach and technique may impact the rate of complications. Minimally invasive procedures appear to have fewer complications compared to laparotomy. These findings contribute to the understanding of the surgical management of concurrent RP and POP and can guide clinical decision-making in the treatment of these conditions.

Keywords

retrospective review

female patients

combined rectal prolapse

pelvic organ prolapse

surgery

surgical approach

complications

recurrence rates

perineal route

abdominal route