E-Posters-Trends in the Surgical Management of Combined Vaginal and Rectal Prolapse following the Initiation of a Multi-Disciplinary Pelvic Floor Center

Trends in the Surgical Management of Combined Vaginal and Rectal Prolapse following the Initiation of a Multi-Disciplinary Pelvic Floor Center - Shannon L. Wallace, MD

Back to course

Pdf Summary

A retrospective review was conducted to characterize changes in the surgical management of combined vaginal prolapse (POP) and rectal prolapse (RP) following the initiation of a multi-disciplinary pelvic floor center. The study collected data on patient demographics, surgical approach, and outcomes for female patients who received combined RP and POP surgery at a single tertiary care center from 2008-2019.<br /><br />The results showed a significant increase in the number of combined surgeries after the initiation of the multi-disciplinary center. The use of laparoscopic/robotic abdominal approach for RP repair increased, as did the use of mesh-based repair for both RP and POP. Before the center was established, open abdominal and transperineal repairs were more common for RP, and suture-based suspensions were more common for POP.<br /><br />Patient characteristics, such as age, race/ethnicity, BMI, and comorbidities, were similar before and after the center was established. However, patients treated after the center's initiation were less likely to be former or current smokers.<br /><br />The study concludes that a dedicated multi-disciplinary pelvic floor center can significantly increase the opportunity for combined surgeries for the treatment of vaginal and rectal prolapse. The increasing utilization of minimally-invasive approaches for RP and mesh-based repairs for POP highlights the importance of continued training in these procedures, despite the controversy surrounding mesh use in pelvic reconstruction.<br /><br />Overall, the findings suggest that combined surgical repair for vaginal and rectal prolapse via suture or mesh fixation to the sacral promontory is safe and has good outcomes. The establishment of a multi-disciplinary center with a dedicated pelvic floor colorectal surgeon can improve access to combined surgeries and optimize the treatment of patients with combined prolapse.

Meta Tag

Concept Pelvic Floor Center

Concept Rectal Prolapse

Concept Vaginal Prolapse

Concept Surgical Management

Concept Abdominal Surgery

Keywords

retrospective review

surgical management

combined prolapse

multi-disciplinary center

laparoscopic/robotic approach

mesh-based repair

suture-based suspensions

patient demographics

treatment outcomes

pelvic floor colorectal surgeon

Pelvic Floor Center

Rectal Prolapse

Vaginal Prolapse

Surgical Management

Abdominal Surgery