Laparoscopic Supralevator Repair for Combined Apical and Posterior Compartment Prolapse

Study ObjectiveTo analyze the objective outcome of laparoscopic supralevator repair in the treatment of rectoenterocele with the Pelvic Organ Prolapse Quantification (POPQ) system.Study DesignRetrospective cohort study 1999–2009 (Canadian Taskforce Classification II–2).SettingUniversity hospital in South Australia.PatientsA total of 166 women with a median age of 63 years (range 36–89) who underwent laparoscopic supralevator repair for rectoenterocele and treatment of associated conditions over a 10-year period.InterventionsAll patients were assessed with the POPQ scoring system before surgery and at 6 weeks, 6 months, annually, and biannually after surgery.Measurements and Main ResultsThe median operating time was 151 minutes (range 35–390); median blood loss was 50 mL (range 50–600); and median hospital stay was 4 days (range 1–14). Four women, 2 of whom required laparotomy, had a major complication. Ten women (6%) needed day surgery to treat vaginal granulations or suture exposure. With a median follow-up time of 45 months (interquartile range 16–67) the overall objective success rate was 63% according to National Institute of Health criteria. The median time to failure was 24 months. Of 61 objective failures, 23 required further prolapse surgery, representing a 14% reoperation rate.ConclusionLaparoscopic supralevator repair is a safe and effective procedure for the treatment of rectoenterocele.