Laparoscopic supralevator repair for combined apical and posterior compartment prolapse

Study Objective: To analyze the objective outcome of laparoscopic supralevator repair in the treatment of rectoenterocele with the Pelvic Organ Prolapse Quantification (POPQ) system. Study Design: Retrospective cohort study 1999-2009 (Canadian Taskforce Classification II-2). Setting: University hospital in South Australia. Patients: A total of 166 women with a median age of 63 years (range 36-89) who underwent laparoscopic supralevator repair for rectoenterocele and treatment of associated conditions over a 10-year period. Interventions: All patients were assessed with the POPQ scoring system before surgery and at 6 weeks, 6 months, annually, and biannually after surgery. Measurements and Main Results: The median operating time was 151 minutes (range 35-390); median blood loss was 50 mL (range 50-600); and median hospital stay was 4 days (range 1-14). Four women, 2 of whom required laparotomy, had a major complication. Ten women (6%) needed day surgery to treat vaginal granulations or suture exposure. With a median follow-up time of 45 months (interquartile range 16-67) the overall objective success rate was 63% according to National Institute of Health criteria. The median time to failure was 24 months. Of 61 objective failures, 23 required further prolapse surgery, representing a 14% reoperation rate. Conclusion: Laparoscopic supralevator repair is a safe and effective procedure for the treatment of rectoenterocele.