Premium
Pregnancy after laparoscopic ventral mesh rectopexy: implications and outcomes
Author(s) -
Hogan A. M.,
Tejedor P.,
Lindsey I.,
Jones O.,
Hompes R.,
Gorissen K. J.,
Cunningham C.
Publication year - 2017
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13818
Subject(s) - medicine , pelvic floor , pregnancy , vaginal delivery , caesarean section , general surgery , presentation (obstetrics) , rectal prolapse , surgery , retrospective cohort study , referral , obstetrics , rectum , nursing , genetics , biology
Aim Surgical management of rectal prolapse varies considerably. Most surgeons are reluctant to use ventral mesh rectopexy in young women until they have completed their family. The aim of the present study was to review outcomes of pregnancy following laparoscopic ventral mesh rectopexy from a tertiary referral centre over a 10‐year period (2006–2016) and to review the impact on pelvic floor symptoms. Method We undertook a retrospective review of a prospectively compiled database of patients who had undergone laparoscopic ventral rectopexy in a single centre over a 10‐year period. Pelvic floor symptom scores (Vaizey for incontinence and Longo for obstructive defaecation) were collected at initial presentation (pre‐intervention), post‐intervention and after child birth. Results In all, 954 rectopexies were performed over this 10‐year period. 225 (24%) patients were women and under 45 years of age (taken as an arbitrary cut‐off for decreased likelihood of pregnancy). Eight (4%) of these patients became pregnant following rectopexy. The interval between rectopexy and delivery was 42 months (21–50). Six patients delivered live babies by elective lower segment caesarean section and two by spontaneous vaginal delivery. Six were first babies and two were second. No mesh related adverse outcome was reported. No difference in pelvic floor symptoms was demonstrated on comparison of post‐rectopexy and post‐delivery scores. Conclusion This study provides the first description in the English language literature of safe delivery by elective lower segment caesarean section or spontaneous vaginal delivery following laparoscopic ventral mesh rectopexy. No adverse impact on pelvic floor related quality of life was detected.