Abdominal Colporectopexy with Pelvic Cul-De-Sac Closure

Abstract

The problem of coexisting rectal and posthysterectomy vaginal vault prolapse can be corrected by combined abdominal colporectopexy and closure of the pelvic cul-de-sac. For 89 patients this operation provided considerable relief of symptoms, with no evidence of recurrence of rectal or vaginal vault prolapse at follow-up.

Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation

“…For more complex diseases, the combined perinealabdominal colporectopexy and Douglas pouch obliteration give satisfactory results as they deal also with enterocele and peritoneocele, frequently causing obstructed defecation after hysterectomy, whose correction is not taken under consideration by DSP [14,15]. It should be stressed that R-IMP is only the tip of the iceberg in most patients with outlet obstruction [16]: a number of other lesions may be present, including genital prolapse, enterocele, non-relaxing puborectalis, slow-transit constipation, pudendal neuropathy, anxiety and depression.…”

Feasibility and Functional Outcome of Laparoscopic Sacrocolporectopexy for Combined Vaginal and Rectal Prolapse

“…The procedure required the same amount of time as a standard laparoscopic mesh rectopexy since the perineal (vaginal) part of the operation is carried out concurrent with the laparoscopic part of the procedure. Despite reports that the laparoscopic approach may be difficult in patients who have had previous open hysterectomy because of a higher likelihood of small bowel adhesions in the pelvis, 10 we did not select against patients who had undergone previous pelvic surgery. However, 4 of 10 patients in our series had recurrence after open organ prolapse surgery and no additional difficulties or complications were noted during any laparoscopic repairs.…”

Laparoscopic rectovaginopexy for rectal prolapse

“…Only one slip of the mesh is used. In another recently described technique of (open) colporectopexy, Collopy and Barham [18] combined the classic Wells rectopexy with a mesh fixation of the vaginal vault. The dissection of the rectovaginal septum and its stretching and the reinforcement by a Prolene mesh make this procedure also suitable for correction of an anterior rectocele.…”

“…Current laparoscopic treatment of rectal prolapse includes suture rectopexy [14], stapled rectopexy [15,16], posterior mesh rectopexy with artificial material [17,18] and resection of the sigmoid colon with colorectal anastomosis [19] with or without rectopexy [20]. Laparoscopic techniques used for anterior rectocele are suture or mesh rectopexy [21,22].…”