Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study

• Published in: BMC surgery 2024-06, Vol.24 (1), p.185-13
• Main Authors: Rudroff, Claudia, Madukkakuzhy, Joshy, Hernandez, Alberto Vega, Otten, Jakob, Ulrici, Christoph, Karapanos, Leonidas, Ludwig, Sebastian
• Format: Article
• Language: English
• Subjects: Aged; Anastomotic leak; Biological mesh; Clinical trials; Constipation - etiology; Constipation - surgery; Defecation; Defecation - physiology; Evaluation; Evidence-based medicine; FDA approval; Female; Gynecologic Surgical Procedures - methods; Humans; Interdisciplinary aspects; Intestinal obstruction; Intestine; Laparoscopic surgery; Laparoscopy; Laparoscopy - methods; Medical research; Medicine, Experimental; Middle Aged; Morbidity; Obstructed defecation syndrome; Patients; Pelvic organ prolapse; Pelvic Organ Prolapse - complications; Pelvic Organ Prolapse - surgery; Pelvis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Pregnancy; Prolapse; Quality of life; Questionnaires; Rectum; Rectum - surgery; Resection rectopexy; Retrospective Studies; Sacrocolpopexy; Subgroups; Surgery; Surgical Mesh; Sutures; Syndrome; Synthetic mesh; Treatment Outcome; Urinary incontinence; Uterus; Vagina - surgery; Womens health
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-024-02474-4

Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially compromises quality of life. Conservative management offers limited relief and a surgical intervention may be required. This is characterized by individual approaches. AIM OF THE STUDY: This retrospective single center study evaluated the surgical and clinical short-term outcome of a novel interdisciplinary laparoscopic resection rectopexy (L-RRP) with mesh- sacrocolpopexy (L-SCP) for women suffering from ODS and POP. The study participants underwent surgery in an interdisciplinary laparoscopic approach. Safety was the primary endpoint, assessed via postoperative morbidity classified by Clavien-Dindo scale. Secondary outcomes included evaluation of bowel function, fecal and urinary incontinence and pelvic organ prolapse status at 12 months follow-up. Additionally, a biological mesh (BM) was offered to women, who asked for an alternative to synthetic mesh material (SM). Of the 44 consecutive patients requiring surgery for ODS and POP, 36 patients underwent the interdisciplinary surgical approach; 28 patients with SM and 8 patients with BM. In total 5 complications occurred, four of them were classified as minor. One minor complication was observed in the BM group. One anastomotic leakage occurred in the SM group. The two ODS scores, the bowel dysfunction score, and the incontinence score improved significantly (p = 0.006, p = 0.003, p