Article
Interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy using biological mesh compared to synthetic mesh for the treatment of obstructive defecation disorders and pelvic organ prolapse in women – first results
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Published: | November 4, 2021 |
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Introduction: The treatment of obstructed defecation syndrome (ODS) in association with POP is currently characterized by individual approaches and methods. Sufficient data on standardized treatment options to give evidence-based advice to the women suffering is still missing. Women are treated by individual departments in a variety of individual approaches and the cases are seldom discussed between disciplines.
In urogynecological surgery, biological meshes are currently not recommended for sacrocolpopexy. However, the evidence is sparse. Increasing evidence will form the basis for standardized care for the benefit of our patients at a time when the use of a synthetic meshes is being debated.
In this pilot study we initiated an interdisciplinary surgical approach and included a novel treatment option using a biological mesh material for our patients.
Methods: Women who presented with an ODS combined with POP were operated in an interdisciplinary approach. All patients underwent laparoscopic resection rectopexy with mesh sacrocolpopexy using either synthetic or biologic mesh.
Results: So far, 26 patients have been operated so far. The table summarizes the results with a median follow-up of 10 months (3–15 months) (Table 1 [Fig. 1]).
Conclusion: Based on these results to date, we advocate for the interdisciplinary approach. The use of a biological mesh in this setting is safe and feasible and offers an additional treatment option, especially for younger and fertile women.
In a further step, we plan a confirmatory multicenter trial to confirm that the biological mesh material offers comparable outcomes to synthetic mesh with. The increasing evidence will form the basis for standardized care for the benefit of our patients at a time when the use of a synthetic meshes is being debated.
Conflict of interest: Dr. S. Ludwig, Reisekostenunterstützung und Honorare der FEG Textiltechnik mbH Aachen