Could the results of posterior colporrhaphy and levatoroplasty be improved by abdominal sacrocolporectopexy?

Oleynik, Natalia V; Kulikovsky, Vladimir F; Abulatifa, Ahmed; Krivchikova, Arina P; Bratisheva, Natalia N; Alenicheva, Marina S; Storojilov, Dmitry A; Naumov, Andrey V

AIM The aim of our study was to improve poor results of preliminary colporrhaphy and anterior levatoroplasty performed for patients with low and middle rectocele. MATIRIAL OF STUDY 55 patients who had undergone colporrhaphy and anterior levatoroplasty for rectocele in 2012- 2015 and contacted the clinic with complaints of ongoing obstructive defecation were included in this investigation. They had a comprehensive medical examination using defecography, ultrasound, magnetic resonance imaging, anorectal functional tests. This study revealed perineum descending in 20 patients, apical prolapse 23 patients, and 12 patients demonstrated simultaneous pathology. All these patients were performed additional abdominal sacrocolporectopexy in 2015-2017 and results were estimated. RESULTS Abdominal sacrocolporectopexy significantly improved anatomical and functional results of previous surgery which was confirmed by the listed methods of research. The average location of the anorectal area and utero-cervical zone became higher. So, perineum descendents and apical prolapsed were improved. DISCUSSION Sacrocolporectopexy is often used for surgical treatment of pelvic organ prolapse. Our study shows its efficiency in patients with perineum descending and upper rectocele. CONCLUSIONS Abdominal sacrocolporectopexy is an effective method of surgical correction of relapses and unsatisfactory results of treatment of patients with pelvic prolapse, manifested by perineum body descending and apical prolapse. KEY WORDS Apical prolapse, Levatoroplasty, Perineum descending, Rectocele, Sacrocolporectopexy.