Laparoscopic posterior rectopexy for complete prolapse of the rectum: Our experience

Abstract

Background: Total rectal prolapse is a disorder that affects both sexes in all age groups causing debilitating symptoms along with constipation, incontinence or both and results in a poor quality of life (QoL). Aim: We present our experience of laparoscopic rectopexy for procidencia in terms of change in scores of these factors following surgery and the long term results. Materials and Methods: This is a retrospective study with prospectively collected data. Fifteen patients who underwent laparoscopic rectopexy for complete rectal prolapse in our unit from January 2013 to 2016 were included. Preoperative and postoperative constipation, incontinence and QoL scores have been followed up for a period of 18 months following surgery. Other outcomes measured were major and minor complications, length of hospital stay and recurrence. Results: Almost all patients suffered from pre-operative incontinence and had a poor QoL before surgery. Improvement in incontinence following surgery was seen in 86.7% and improvement in constipation was seen in 53% of the patients. There were no major complications. Retrograde ejaculation was seen in two patients in the 20–30 year age group. One patient recovered partially in 6 months and the other was lost to follow-up. There was no incidence of recurrence in the median follow-up period. Conclusions: Laparoscopic rectopexy for rectal prolapse is associated with good post-operative outcome as far as incontinence and constipation is concerned. There is a significant improvement in QoL and associated with a low risk of recurrence. There is a risk of sexual disorders following 'posterior rectopexy' among sexually active males and can be a major source of dissatisfaction.

Keywords

• laparoscopic rectopexy
• outcomes
• rectal prolapse