Our Summary

This study looked at the outcomes of a specific type of surgery, called minimally invasive ventral mesh rectopexy (VMR), which is used to treat a condition where the pelvic organs drop down, known as posterior pelvic organ prolapse. Specifically, the research focused on cases where the surgery had to be repeated due to the condition recurring.

The study analyzed data from patients who had to undergo this surgery again between 2011 and 2016 in three hospitals in Finland. The data included information about the patients, details about the surgery and recovery, and follow-up information about their symptoms and quality of life after the surgery.

The study found that a total of 43 surgeries were performed again during the study period. In most cases, the original mesh used in the surgery was left in place and a new one was added. Some patients experienced complications, including issues related to the mesh. The rate of the condition recurring after the repeat surgery was quite low, at 4.5%. A few patients needed further surgery for different reasons.

The study concluded that repeating the minimally invasive VMR surgery can be a safe and effective way to treat posterior pelvic floor dysfunction, with acceptable rates of the condition recurring and further surgery needed. Patients who had the surgery repeated because their condition had come back seemed to benefit more from the repeat surgery.

FAQs

  1. What is minimally invasive ventral mesh rectopexy (VMR) surgery?
  2. What was the recurrence rate of the condition after the repeat VMR surgery according to the study?
  3. Did the study find repeating the VMR surgery to be a safe and effective treatment for posterior pelvic floor dysfunction?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about rectal prolapse surgery is to follow all post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include avoiding heavy lifting, staying physically active to promote healing, eating a high-fiber diet to prevent constipation, and attending all follow-up appointments with your healthcare provider. It is also important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended rectal prolapse surgery are those who have tried conservative treatments such as pelvic floor exercises and dietary changes without success, and are experiencing significant symptoms such as difficulty with bowel movements, fecal incontinence, and pelvic pressure or discomfort. In particular, patients with posterior pelvic organ prolapse may be recommended for minimally invasive ventral mesh rectopexy (VMR) surgery.

Patients who have had previous rectal prolapse surgery that has failed or resulted in recurrence of symptoms may also be candidates for repeat surgery, as seen in the study mentioned above. These patients may benefit from a repeat surgery to address the underlying issues causing their symptoms and improve their quality of life.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if rectal prolapse surgery is the right choice for them. Each patient’s case is unique, and the decision to undergo surgery should be based on a thorough evaluation of their individual circumstances and medical history.

Timeline

Before rectal prolapse surgery:

  1. Patient experiences symptoms of rectal prolapse, such as feeling a bulge or protrusion from the rectum.
  2. Patient consults with a healthcare provider who may recommend non-surgical treatments first, such as pelvic floor exercises or dietary changes.
  3. If non-surgical treatments are unsuccessful, the healthcare provider may recommend rectal prolapse surgery as a treatment option.

After rectal prolapse surgery:

  1. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.
  2. The surgery is performed, which may involve different techniques such as minimally invasive ventral mesh rectopexy (VMR).
  3. Patient recovers in the hospital for a few days following the surgery, with pain management and monitoring of any potential complications.
  4. Patient is discharged from the hospital and continues to recover at home, following post-operative care instructions provided by their healthcare team.
  5. Patient attends follow-up appointments with their healthcare provider to monitor their progress and address any concerns.
  6. Over time, the patient should experience improvement in their symptoms of rectal prolapse and overall quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rectal prolapse surgery include:

  1. What are the risks and benefits of minimally invasive ventral mesh rectopexy (VMR) surgery for treating rectal prolapse?
  2. How likely is it that I will need to undergo surgery again in the future?
  3. What complications can occur with rectal prolapse surgery, including issues related to the mesh used?
  4. How long is the recovery process after rectal prolapse surgery and what can I expect during this time?
  5. What are the success rates of repeat surgery for rectal prolapse and how will my quality of life be affected after the surgery?
  6. Are there any alternative treatments for rectal prolapse that I should consider?
  7. How experienced are you in performing minimally invasive VMR surgery and what is your success rate with this procedure?
  8. Will I need to make any lifestyle changes or follow a specific post-operative care plan after rectal prolapse surgery?
  9. Can you provide me with information about other patients who have undergone repeat rectal prolapse surgery and their outcomes?
  10. Are there any long-term effects or complications I should be aware of after undergoing rectal prolapse surgery?

Reference

Authors: Laitakari KE, Mäkelä-Kaikkonen JK, Kairaluoma M, Junttila A, Kössi J, Ohtonen P, Rautio TT. Journal: Tech Coloproctol. 2021 Mar;25(3):299-307. doi: 10.1007/s10151-020-02369-5. Epub 2020 Nov 5. PMID: 33151385