Surgical approach, complications, and reoperation rates of combined rectal and pelvic organ prolapse surgery
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ORIGINAL ARTICLE
Surgical approach, complications, and reoperation rates of combined rectal and pelvic organ prolapse surgery Shannon L. Wallace 1
&
Raveen Syan 2 & Ekene A. Enemchukwu 3 & Kavita Mishra 1 & Eric R. Sokol 1 & Brooke Gurland 4
Received: 12 March 2020 / Accepted: 9 June 2020 # The International Urogynecological Association 2020
Abstract Objectives Our primary objective was to determine rectal prolapse (RP) and pelvic organ prolapse (POP) reoperation rates and postoperative < 30-day complications after combined RP and POP surgery at a single institution. Methods This was an IRB-approved retrospective cohort study of all female patients who received combined RP and POP surgery at a single tertiary care center from 2008 to 2019. Recurrence was defined as the need for subsequent repeat RP or POP surgery at any point after the index surgery. Surgical complications were separated into Clavien-Dindo classes. Results Sixty-three patients were identified, and 18.3% (12/63) had < 30-day complications (55% Clavien-Dindo grade 1; 27% Clavien-Dindo grade 2; 18% Clavien-Dindo grade 4). Of patients undergoing combined abdominal RP and POP repair, no postoperative < 30-day complications were noted in the MIS group compared to 37.5% of those patients in the laparotomy group (p < 0.01). Overall, in those patients who underwent combined RP and POP surgery, the need for subsequent RP surgery for recurrent RP was 14% and the need for subsequent POP surgery for recurrent POP was 4.8% (p = 0.25). Conclusion In this cohort of women undergoing combined RP and POP surgery, a higher proportion required subsequent RP surgery compared to those requiring subsequent POP surgery, although this was not statistically significant. Almost one-fifth of patients undergoing combined RP and POP surgery experienced a < 30-day surgical complication, regardless of whether the approach was perineal or abdominal. For those patients undergoing abdominal repair, < 30-day complications were more likely in those patients who had a laparotomy compared to those who had a minimally invasive surgery. Keywords Combined rectal prolapse and pelvic organ prolapse surgery . Pelvic organ prolapse . Rectal prolapse . Rectopexy . Recurrence . Sacrocolpopexy . Surgical complications
Introduction Presented at the 2019 AUGS/IUGA Meeting, Nashville, TN, USA, and 2019 ICS Meeting, Gothenburg, Sweden This study was approved by the Stanford Ethics Institutional Review Board (IRB). * Shannon L. Wallace [email protected]; [email protected] 1
Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
2
Department of Urology, Division of Female Urology, University of Miami, Miami, FL, USA
3
Department of Urology, Division of Female Urology, Stanford University School of Medicine, Palo Alto, CA, USA
4
Department of Surgery, Division of Colorectal Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
External rectal prolapse (RP)
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