Botoncea Marian, Molnar Călin, Nicolescu Cosmin-Lucian, Baltă Cătălin, Butiurca Vlad-Olimpiu, Martha Orsolya, Molnar Claudiu Varlam
Surgical Clinic No. 1, Emergency County Hospital Târgu Mureș, "G.E. Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania.
Surgical Clinic No. 1, Emergency County Hospital Târgu Mureș, Târgu Mureș, Romania.
Medicine (Baltimore). 2025 Aug 1;104(31):e43648. doi: 10.1097/MD.0000000000043648.
Concurrent pelvic organ prolapse (POP) and rectal prolapse is a rare condition that poses significant therapeutic challenges. A customized, multidisciplinary strategy is frequently required, particularly in complex cases with underlying functional deficits.
A 71-year-old woman presented with stage III POP and grade V rectal prolapse. Her history included no pregnancies or vaginal intercourse, and she previously underwent sacral tumor excision resulting in anal and urinary incontinence, requiring long-term catheterization.
Preoperative clinical examination and imaging (transabdominal and transvaginal ultrasound) confirmed the diagnosis of stage III POP and grade V rectal prolapse. Routine blood tests, vaginal bacteriological cultures, and Pap smear were unremarkable.
The patient underwent a multidisciplinary surgical procedure including hysterectomy, sacrocolpopexy, and rectopexy using a Pro-Grip™ self-fixating mesh. The mesh was placed to anchor the vaginal stump and provide rectal support simultaneously.
The patient had an uneventful recovery, with drain removal on postoperative day 5 and discharge on day 7. Follow-up at 3 months, 6 months, and 1 year showed no recurrence of prolapse. The patient declined additional imaging at 1 year, considering herself fully recovered.
This case demonstrates that a self-fixating mesh can provide effective concurrent repair of POP and rectal prolapse in a single procedure. Short-term outcomes were favorable, but long-term follow-up remains essential to assess durability and potential complications.
盆腔器官脱垂（POP）与直肠脱垂并存是一种罕见的病症，带来了重大的治疗挑战。通常需要一种定制的多学科策略，尤其是在伴有潜在功能缺陷的复杂病例中。
一名71岁女性，患有Ⅲ期盆腔器官脱垂和Ⅴ级直肠脱垂。她无妊娠及阴道性交史，曾接受骶骨肿瘤切除术，导致肛门和尿失禁，需要长期导尿。
术前临床检查及影像学检查（经腹及经阴道超声）确诊为Ⅲ期盆腔器官脱垂和Ⅴ级直肠脱垂。常规血液检查、阴道细菌培养及巴氏涂片检查均无异常。
患者接受了多学科手术，包括子宫切除术、骶骨阴道固定术和使用Pro-Grip™自固定补片的直肠固定术。放置补片以固定阴道残端并同时提供直肠支撑。
患者恢复顺利，术后第5天拔除引流管，第7天出院。3个月、6个月和1年的随访显示脱垂未复发。患者在1年时拒绝进一步影像学检查，认为自己已完全康复。
本病例表明，自固定补片可在单次手术中有效同时修复盆腔器官脱垂和直肠脱垂。短期结果良好，但长期随访对于评估耐久性和潜在并发症仍然至关重要。
