Kato Takehiro, Kato Kumiko, Kurumiya Yasuhiro
Department of Surgery, Toyota Kosei Hospital, 500-1 Josui-Cho, Toyota, Aichi, 470-0396, Japan.
Department of Female Urology, Meitetsu Hospital, Nagoya, Japan.
Int Urogynecol J. 2024 Jun;35(6):1323-1326. doi: 10.1007/s00192-024-05788-2. Epub 2024 May 1.
The aim of this video case series is to demonstrate our experience of the clinical findings and the surgical management of the rapid onset de novo rectal prolapse (RP) following colpocleisis METHODS: This is a case series of three patients who developed de novo RP within 1 month after colpocleisis, which was repaired by laparoscopic ventral mesh rectopexy (LVMR). The video shows the physical, radiological, and intraoperative findings of these patients. A retrospective review of our surgical cases of RP was also performed to analyze the onset timing of de novo RP after various pelvic organ prolapse (POP) procedures.
The pathological condition of all three patients' RP was evacuation enterocele, and LVMR was feasible without postoperative complications or recurrences. In the retrospective case review of 158 RP surgeries in our institution (June 2015 to September 2023), 18 cases (11.4%) occurred following POP surgery. De novo RP following colpocleisis developed significantly earlier than those following other procedures (average: 6.1 vs 66.4 months, p = 0.010).
Although de novo RP following colpocleisis is relatively rare, this complication could have a detrimental effect on patients' quality of life. Preoperative informed consent may be advisable before planning colpocleisis.
本视频病例系列的目的是展示我们在阴道封闭术后快速发生的原发性直肠脱垂（RP）的临床发现及手术治疗经验。
这是一个包含三名患者的病例系列，她们在阴道封闭术后1个月内发生原发性RP，并通过腹腔镜腹侧补片直肠固定术（LVMR）进行修复。视频展示了这些患者的体格检查、影像学检查及术中发现。我们还对RP手术病例进行了回顾性分析，以探讨各种盆腔器官脱垂（POP）手术后原发性RP的发病时间。
所有三名患者的RP病理情况均为排空型肠膨出，LVMR手术可行，术后无并发症或复发。在我们机构对158例RP手术（2015年6月至2023年9月）的回顾性病例分析中，18例（11.4%）发生在POP手术后。阴道封闭术后原发性RP的发生明显早于其他手术（平均：6.1个月对66.4个月，p = 0.010）。
虽然阴道封闭术后原发性RP相对少见，但这种并发症可能对患者生活质量产生不利影响。在计划进行阴道封闭术前，建议进行术前知情同意。
