Laparoscopic ventral rectopexy for rectal prolapse and symptomatic rectocele: an analysis of 245 consecutive patients

Aim This retrospective study aimed to determine functional results of laparoscopic ventral rectopexy ( LVR ) for rectal prolapse ( RP ) and symptomatic rectoceles in a large cohort of patients. Method All patients treated between 2004 and 2011 were identified. Relevant patient characteristics were gathered. A questionnaire concerning disease‐related symptoms as well as the Cleveland Clinic Incontinence Score ( CCIS ) and Cleveland Clinic Constipation Score ( CCCS ) was sent to all patients. Results A total of 245 patients underwent operation. Twelve patients (5%) died during follow‐up and were excluded. The remaining patients (224 women, nine men) were sent a questionnaire. Indications for LVR were external RP ( n  =   36), internal RP or symptomatic rectocele ( n  =   157) or a combination of symptomatic rectocele and enterocele ( n  =   40). Mean age and follow‐up were 62 years (range 22–89) and 30 months (range 5–83), respectively. Response rate was 64% (150 patients). The complication rate was 4.6% (11 complications). A significant reduction in symptoms of constipation or obstructed defaecation syndrome was reported (53% of patients before vs 19% after surgery, P  <   0.001). Mean CCCS during follow‐up was 8.1 points (range 0–23, SD  ± 4.3). Incontinence was reported in 138 (59%) of the patients before surgery and in 32 (14%) of the patients after surgery, indicating a significant reduction ( P  <   0.001). Mean CCIS was 6.7 (range 0–19, SD  ± 5.2) after surgery. Conclusion A significant reduction of incontinence and constipation or obstructed defaecation syndrome after LVR was observed in this large retrospective study. LVR therefore appears a suitable treatment for RP and rectocele with and without associated enterocele.