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. 2022 Jun;104(6):449-455.
doi: 10.1308/rcsann.2021.0212. Epub 2021 Dec 23.

A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse

O Olatunbode  1 , S Rangarajan  1 , V Russell  2 , Yks Viswanath  1   2 , A Reddy  1   3
Affiliations

A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse

O Olatunbode et al. Ann R Coll Surg Engl. 2022 Jun.

Abstract

Introduction: Rectal prolapse is a life-altering problem and laparoscopic ventral mesh rectopexy (LVMR) is emerging as the surgical intervention of choice. However, the literature is ambiguous on its effect on bowel function and sparse as regards bladder and sexual function. This study assesses short-term functional outcomes following LVMR.

Materials and methods: This quantitative retrospective study with a pretest-post-test design included 130 adults who had undergone LVMR from October 2010 to December 2018 in a tertiary centre. Analysis with paired-samples t-test and Wilcoxon matched pairs test was done using SPSS (v26).

Results: The median age was 58 years (interquartile range, 48-74 years); 123 (94.6%) were female. The median length of stay was two days (interquartile range, 1-2 days). A total of 104 (80%) sets of medical notes were reviewed. One patient had recurrence of rectal prolapse. Synthetic mesh was used in 24 patients (23.1%) and biological mesh in 80 (76.9%). One patient had extrusion of a synthetic mesh and required surgery; 31(23.8%) completed the Electronic Patient Assessment Questionnaire for Pelvic Floor. Overall, the improvement in bladder function was not statistically significant (p = 0.670). A statistically significant improvement was seen for all bowel symptoms (p = 0.002) excluding constipation (p = 0.295). Irritable bowel symptoms associated with rectal prolapse improved significantly following LVMR (p = 0.001). Vaginal prolapse (p < 0.0005), dyspareunia (p = 0.001) and bowel symptoms affecting sexual intercourse (p = 0.01) improved, but improvement in overall sexual function was not statistically significant (p = 0.081).

Conclusions: LVMR improves bowel function overall, although it can worsen constipation. It has the potential to improve sexual function but makes negligible difference to bladder function.

Keywords: Functional outcomes; Quality of life; Rectal prolapse; Ventral mesh rectopexy.

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Figures

Figure 1
Figure 1
Laparoscopic ventral mesh rectopexy performed per year
Figure 2
Figure 2
Radar plot comparing quality of life (QOL) outcome measures
See this image and copyright information in PMC

Comment in

  • A biologic dare?
    Vénara A, Meurette G. Vénara A, et al. J Visc Surg. 2024 Feb;161(1):1-2. doi: 10.1016/j.jviscsurg.2023.11.007. Epub 2023 Dec 1. J Visc Surg. 2024. PMID: 38042679 No abstract available.

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