Review of results of laparoscopic ventral mesh rectopexy
Research type
Research Study
Full title
Assessment of bowel, sexual function and quality of life after laparoscopic ventral mesh rectopexy
IRAS ID
256512
Contact name
Andrew Williams
Contact email
Sponsor organisation
Guy’s and St Thomas’ NHS Foundation Trust R&D Department
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Defaecation difficulties related to the pelvic floor can produce a variety of non-specific symptoms such as constipation, stool trapping, faecal leakage, pelvic pressure, vaginal bulge and prolapse. This is often caused by changes in the disposition of the lower part of the bowel (rectum) that can cause bulging into the posterior vaginal wall (rectocoele); infolding of the rectal wall inside the rectum or anus (internal rectal prolapse or intussusception) or protrusion of the rectal wall outside the anus (external rectal prolapse). In those patients who don’t get better after conservative treatment with Biofeedback, an operation to pull the rectum up and put it back to its normal position in the body aims to improve their defaecation.
Laparoscopic ventral mesh rectopexy (LVMR) is a keyhole operation for the treatment problems such as external rectal prolapse but also symptomatic internal rectal prolapse (intussusception) and large rectocoeles. The operation will release the rectum from the back of the vagina and a mesh is fastened to the front of the rectum using stiches and then fixed to the bone at the spine, to pull up the bowel and preventing it from falling downwards but also to strengthen the space between the rectum and the vagina to prevent further bulging. The mesh (a sterile sheet of netting) may be biological (made from bodily tissue) or synthetic (made from non-natural materials).
Nevertheless, correcting the bowel position through surgery might not always improve the patients’ symptoms, so we should focus on the patient’s subjective improvement as indicator of successful surgical treatment. Improvement of symptoms as well as their quality of life is a primary reason for these patients to undergo a surgical procedure. There has also been recent concerns about the use of mesh in pelvic floor surgery, and although it has been proven that there is a low rate of mesh related complications of less than 1%, it is even more important today to address the impact of this surgery in patient’s wellbeing and symptom resolution.
This study will retrospectively contact patients who have had laparoscopic ventral mesh rectopexy to assess their bowel, sexual function and quality of life after the surgical procedure. We will assess patients through 4 validated questionnaires; the Pelvic Floor Impact Questionnaire-short form 7, Pelvic Floor Distress Inventory Questionnaire Short Form 20, Obstructed Defaecation symptom score, Female Sexual Function Index.
REC name
London - Westminster Research Ethics Committee
REC reference
19/LO/0985
Date of REC Opinion
6 Aug 2019
REC opinion
Further Information Favourable Opinion