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Surgical approach, complications, and reoperation rates of combined rectal and pelvic organ prolapse surgery

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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.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA, USA

    Shannon L. Wallace, Kavita Mishra & Eric R. Sokol

  2. Department of Urology, Division of Female Urology, University of Miami, Miami, FL, USA

    Raveen Syan

  3. Department of Urology, Division of Female Urology, Stanford University School of Medicine, Palo Alto, CA, USA

    Ekene A. Enemchukwu

  4. Department of Surgery, Division of Colorectal Surgery, Stanford University School of Medicine, Palo Alto, CA, USA

    Brooke Gurland

Authors
  1. Shannon L. Wallace
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  2. Raveen Syan
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  3. Ekene A. Enemchukwu
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  4. Kavita Mishra
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  5. Eric R. Sokol
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  6. Brooke Gurland
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Contributions

SL Wallace: Project development, Data Collection and management, Data analysis, Manuscript writing/editing.

R Syan: Project development, Data Collection and management, Data analysis, Manuscript writing/editing.

EA Enemchukwu: Project development, Data analysis, Manuscript writing/editing.

K Mishra: Project development, Data analysis, Manuscript writing/editing.

E Sokol: Project development, Data analysis, Manuscript writing/editing.

B Gurland: Project development, Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to Shannon L. Wallace.

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The authors report no conflict of interest.

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This study was approved by the Stanford Ethics Institutional Review Board (IRB).

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Wallace, S.L., Syan, R., Enemchukwu, E.A. et al. Surgical approach, complications, and reoperation rates of combined rectal and pelvic organ prolapse surgery. Int Urogynecol J 31, 2101–2108 (2020). https://doi.org/10.1007/s00192-020-04394-2

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  • DOI: https://doi.org/10.1007/s00192-020-04394-2

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