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Ventral mesh rectopexy. Does a descending perineum impact functional results and quality of life?

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Abstract

Purpose

The impact of perineal descent (PD) on functional outcome and quality of life after ventral mesh rectopexy (VMR) is unknown. The purpose of this study was to analyze the effect of PD on the functional outcome and quality of life (QOL) after VMR.

Methods

A retrospective analysis was performed on fifty-five patients who underwent robotic VMR between 2018 and 2021. Pre and postoperative data along with radiological studies were gathered from a prospectively maintained database. The Cleveland Clinic Constipation score (CCCS), the Rome IV criteria and the 36-Item Short-Form Health Survey (SF-36), were used to measure functional results and QOL.

Results

All 55 patients (mean age 57.8 years) were female. Most patients had radiological findings of severe PD (n = 31) as opposed to mild/moderate PD (n = 24). CCCS significantly improved at 3 months and 1 year post-VMR (mean difference = -4.4 and -5.4 respectively, p < 0.001) with no significant difference between the two groups. The percentage of functional constipation Rome IV criteria only showed an improved outcome at 3 months for severe PD and at 1 year for mild/moderate PD (difference = -58.1% and -54.2% respectively, p < 0.05). Only the SF-36 subscale bodily pain significantly improved in the mild/moderate PD group (mean difference = 16.7, p = 0.002) 3 months post-VMR which subsided after one year (mean difference = 5.5, p = 0.068).

Conclusion

Severe PD may impact the functional outcome of constipation without an evident effect on QOL after VMR. The results, however, remain inconclusive and further research is warranted.

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Data availability

All data is available upon request.

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Abdominal Surgery, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium

    Ali Al-Nejar, Sylvie Van den Broeck, Quinten Smets, Philip Plaeke, Guy Hubens & Niels Komen

  2. Antwerp ReSURG, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Edegem, Belgium

    Ali Al-Nejar, Sylvie Van den Broeck, Quinten Smets, Philip Plaeke, Guy Hubens & Niels Komen

  3. Department of Radiology, Antwerp University Hospital, Edegem, Belgium

    Maarten Spinhoven

  4. Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Guy Hubens

Authors
  1. Ali Al-Nejar
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Contributions

Sylvie Van den Broeck and Niels Komen conceived, planned, and supervised the research. Ali Al-Nejar, Sylvie Van den Broeck, Niels Komen, and Quinten Smets established and contributed to the database. Ali Al-Nejar, Sylvie Van den Broeck and Maarten Spinhoven performed the measurements of the radiographic images. Ali Al-Nejar and Sylvie Van den Broeck performed the analysis of the measurements. Ali Al-Nejar, Sylvie Van den Broeck, Niels Komen, Philip Plaeke and Guy Hubens contributed to the analysis and interpretation of the results. Ali Al-Nejar drafted the manuscript and designed the figures and tables. All authors provided critical feedback and helped shape the research, analysis and manuscript.

Corresponding author

Correspondence to Ali Al-Nejar.

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Ethics approval

Approval was obtained from the ethics committee of University Hospital of Antwerp. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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Al-Nejar, A., Van den Broeck, S., Smets, Q. et al. Ventral mesh rectopexy. Does a descending perineum impact functional results and quality of life?. Langenbecks Arch Surg 409, 44 (2024). https://doi.org/10.1007/s00423-024-03236-9

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