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Benign proctology
Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders
Hong Yoon Jeong, Shi-Jun Yang, Dong Ho Cho, Duk Hoon Park, Jong Kyun Lee
Ann Coloproctol. 2020;36(4):256-263.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2020.02.09
  • 5,467 View
  • 128 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to determine the accuracy of 3-dimensional (3D) pelvic floor ultrasonography and compare it with defecography in assessment of posterior pelvic disorders.
Methods
Eligible patients were consecutive women undergoing 3D pelvic floor ultrasonography at one hospital between August 2017 and February 2019. All 3D pelvic floor ultrasonography was performed by one examiner. A total of 167 patients with suspected posterior pelvic disorder was retrospectively enrolled in the study. The patients were divided into 3 groups according to the main symptoms.
Results
There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. Each modality identified 6 enteroceles. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the 2 diagnostic tests was confirmed using Cohen’s kappa value. Rectocele (kappa, 0.784) and enterocele (kappa, 0.654) both indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa, 0.406) showed moderate agreement, while internal intussusception (kappa, 0.296) had fair agreement.
Conclusion
This study showed good agreement for detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.

Citations

Citations to this article as recorded by  
  • Can we use integrated total pelvic floor ultrasound as a screening tool in defaecatory pelvic floor dysfunction? A prospective evaluation of the accuracy of integrated total pelvic floor ultrasound compared with defaecation proctography
    Charlotte Ralston, Max Reena, Deepa Solanki, Samantha Morris, Alexis M. P. Schizas, Andrew B. Williams, Alison J. Hainsworth
    Colorectal Disease.2025;[Epub]     CrossRef
  • Clinical value of transperineal ultrasound in evaluating the diagnostic grade of rectocele in Chinese women with obstructed defecation syndrome: An observational study
    Yunlin Jiang, Zhimin Fan, Ling Gao, Guangshu Shen, Jingjing Yue, Xiaofeng Wang, Xueping Zheng, Yahong Xue
    Medicine.2024; 103(36): e39259.     CrossRef
  • Rectal prolapse and surgery for faecal incontinence
    Judith Johnston, Athur Harikrishnan
    Surgery (Oxford).2023; 41(7): 449.     CrossRef
  • Role of contrast-enhanced ultrasonography in MR-guided focused ultrasound ablation on uterus fibroids: lesion selection and assessment of ablative effects
    Wen Luo, Pei-di Zhang, Xiao Yang, Jian-min Zheng, Ying Liu, Xing Tang, Hai-jing Liu, Lei Ding, Li-na Pang, Xiao-dong Zhou, Li-wen Liu, Min-wen Zheng
    European Radiology.2022; 32(3): 2110.     CrossRef
  • Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
    Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
    International Journal of Surgery Case Reports.2022; 98: 107524.     CrossRef
  • Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
    Chungyeop Lee, Jong Lyul Lee
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score
    Yongwoo Yune, Hong Yoon Jeong, Duk Hoon Park, Jong Kyun Lee
    Annals of Coloproctology.2021; 37(5): 291.     CrossRef
Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes
Keehoon Hyun, Shi-Jun Yang, Ki-Yun Lim, Jong-Kyun Lee, Seo-Gue Yoon
Ann Coloproctol. 2018;34(3):119-124.   Published online June 30, 2018
DOI: https://doi.org/10.3393/ac.2018.01.31
  • 8,114 View
  • 184 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
Although numerous procedures have been proposed for the treatment of patients with a rectal prolapse, the most effective operation has not yet been established. Minimal rectal mobilization can prevent constipation; however, it is associated with increased recurrence rates. We describe our novel method for a laparoscopic posterolateral rectopexy, which includes rectal mobilization with a posterior-right unilateral dissection, suture fixation to the sacral promontory with a polypropylene mesh (Optilene), and a mesorectal fascia propria that is as wide as possible. The present report describes our novel method and assesses the short-term outcomes of patients.
Methods
Between June 2014 and June 2017, 63 patients (28 males and 35 females) with a full-thickness rectal prolapse underwent a laparoscopic posterolateral (LPL) rectopexy. We retrospectively analyzed the clinical characteristics and postoperative complications in those patients. The outcome of surgery was determined by evaluating the answers on fecal incontinence questionnaires, the results of anal manometry preoperatively and 3 months postoperatively, the patients’ satisfaction scores (0–10), and the occurrence of constipation.
Results
No recurrence was reported during follow-up (3.26 months), and 3 patients reported postoperative complications (wound infection, postoperative sepsis, which was successfully treated with conservative management, and retrograde ejaculation). Compared to the preoperative baseline, fecal incontinence at three months postoperatively showed an overall improvement. The mean patient satisfaction score was 9.55 ± 0.10, and 8 patients complained of persistent constipation.
Conclusion
LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse.

Citations

Citations to this article as recorded by  
  • Anatomical and functional outcomes of rectal prolapse treatment with laparoscopic pelvic organ prolapse suspension versus laparoscopic ventral mesh rectopexy
    Adel Zeinalpour, Alimohammad Bananzadeh, Mohammad Mostafa Safarpour, Sara Shojaei‐Zarghani, Seyede Saeideh Shahidinia, Seyed Vahid Hosseini, Ali Reza Safarpour
    Surgical Practice.2025; 29(1): 26.     CrossRef
  • Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
    Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
    Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
    Annals of Surgical Treatment and Research.2022; 102(4): 234.     CrossRef
  • Laparoscopic Posterolateral Suture Rectopexy for Recurrent Rectal Prolapse in Children
    Sherif M. Shehata, Ahmed A. Elhaddad, Wael M. Abo Senna, Mohamed A. Shehat
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2019; 29(10): 1292.     CrossRef
  • Changing Trend of Rectal Prolapse Surgery in the Era of the Minimally Invasive Surgery
    Suk-Hwan Lee
    The Journal of Minimally Invasive Surgery.2019; 22(4): 135.     CrossRef
Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse
Shi-Jun Yang, Seo-Gue Yoon, Ki-Yun Lim, Jong-Kyun Lee
Ann Coloproctol. 2017;33(2):64-69.   Published online April 28, 2017
DOI: https://doi.org/10.3393/ac.2017.33.2.64
  • 7,859 View
  • 106 Download
  • 15 Web of Science
  • 16 Citations
AbstractAbstract PDF
Purpose

Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness rectal prolapse and/or middle-compartment prolapse. This study assessed the short-term outcomes for patients who underwent laparoscopic vaginal suspension and rectopexy.

Methods

Between April 2014 and April 2016, 69 female patients underwent laparoscopic vaginal suspension and rectopexy to correct a rectal prolapse. Demographics, medical histories, and surgical and follow-up details were collected from their medical records. In addition to the clinical outcome, we repeated defecation proctography and a questionnaire regarding functional results three months after surgery.

Results

No major morbidities or no mortalities occurred. The defecation proctography confirmed excellent anatomical result in all cases. Of 7 patients with combined middle-compartment prolapses, we observed good anatomical correction. During follow-up, full-thickness recurrence occurred in one patient. Preoperative fecal incontinence was improved significantly at 3 months (mean Wexner score: 12.35 vs. 7.71; mean FISI: 33.29 vs. 21.07; P < 0.001). Analysis of responses to the fecal incontinence quality of life (FIQOL) questionnaire showed overall improvement at 3 months compared to the preoperative baseline (mean pre- and postoperative FIQOL scores: 12.11 vs. 14.39; P < 0.004).

Conclusion

Laparoscopic vaginal suspension and rectopexy is a new combined procedure for the treatment of patients with rectal prolapses. It has excellent functional outcomes and minimal morbidity and can correct and prevent middlecompartment prolapses.

Citations

Citations to this article as recorded by  
  • Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
    Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Surgical and Functional Outcome of Laparoscopic Vaginal Suspension Combined with Suture Rectopexy for Management of Pelvic Organ Prolapse
    Mohamed I. Abuelnasr, Ahmed M. F. Salama, Ahmed M. Nawar
    Journal of Coloproctology.2024; 44(01): e1.     CrossRef
  • Mesh-associated complications in minimally invasive ventral mesh rectopexy: a systematic review
    Gabriel Fridolin Hess, Fabio Nocera, Stephanie Taha-Mehlitz, Sebastian Christen, Marco von Strauss Und Torney, Daniel C. Steinemann
    Surgical Endoscopy.2024; 38(12): 7073.     CrossRef
  • Modified robotic ventral rectopexy with folded single titanized mesh suspension for the treatment of complex pelvic organ prolapse
    Bernardina Fabiani, Alessandro Sturiale, Lisa Fralleone, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
    Colorectal Disease.2023; 25(3): 453.     CrossRef
  • Natural Orifice Transanal Endoscopic Rectopexy for Complete Rectal Prolapse: Prospective Evolution of a New Technique and Short-term Outcomes
    Abhijit Chandra, Pritheesh Rajan, Vivek Gupta, Saket Kumar, Mahesh Rajashekhara, Ravi Patel, Bharat Sangal, Vikram Singh
    Diseases of the Colon & Rectum.2023; 66(1): 118.     CrossRef
  • Assessment of feasibility of abdominal mesh vaginorectopexy in the repair of multiple pelvic organ prolapse
    Mohamed Mazloum Zakareya, Walid Galal Elshazly, Ahmed Mohamed Moaz, Bassem Khamis Hegazy
    Alexandria Journal of Medicine.2023; 59(1): 15.     CrossRef
  • A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse
    O Olatunbode, S Rangarajan, V Russell, YKS Viswanath, A Reddy
    The Annals of The Royal College of Surgeons of England.2022; 104(6): 449.     CrossRef
  • Postoperative complications and pelvic organ prolapse recurrence following combined pelvic organ prolapse and rectal prolapse surgery compared with pelvic organ prolapse only surgery
    Shannon L. Wallace, Youngwu Kim, Erica Lai, Shailja Mehta, Bertille Gaigbe-Togbe, Chiyuan Amy Zhang, Emily C. Von Bargen, Eric R. Sokol
    American Journal of Obstetrics and Gynecology.2022; 227(2): 317.e1.     CrossRef
  • A Collaborative Approach to Multicompartment Pelvic Organ Prolapse
    Brooke Gurland, Kavita Mishra
    Clinics in Colon and Rectal Surgery.2021; 34(01): 069.     CrossRef
  • Postoperative complications and recurrence rates after rectal prolapse surgery versus combined rectal prolapse and pelvic organ prolapse surgery
    Shannon L. Wallace, Ekene A. Enemchukwu, Kavita Mishra, Leila Neshatian, Bertha Chen, Lisa Rogo-Gupta, Eric R. Sokol, Brooke H. Gurland
    International Urogynecology Journal.2021; 32(9): 2401.     CrossRef
  • European Society of Coloproctology guidance on the use of mesh in the pelvis in colorectal surgery
    Yasuko Maeda, Eloy Espin‐Basany, Kim Gorissen, Mia Kim, Paul‐Antoine Lehur, Lilli Lundby, Ionut Negoi, Gregor Norcic, P. Ronan O’Connell, Tero Rautio, Bart van Geluwe, Gabrielle H. van Ramshorst, Andrea Warwick, Carolynne J. Vaizey
    Colorectal Disease.2021; 23(9): 2228.     CrossRef
  • Transvaginal rectopexy using the Flex® Colorectal Drive Robotic System: a proof-of-concept approach to rectal prolapse
    J. O. Paull, A. Graham, S. Parascandola, S. Hota, S. Stein, B. Umapathi, A. Abdullah, N. Pudalov, V. Obias
    Techniques in Coloproctology.2020; 24(5): 471.     CrossRef
  • Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
    Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
    World Journal of Clinical Cases.2020; 8(23): 5873.     CrossRef
  • Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
    Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
    World Journal of Clinical Cases.2020; 8(23): 5876.     CrossRef
  • Clinical Outcome and Surgical Technique of Laparoscopic Posterior Rectopexy Using the Mesh With Anti-adhesion Coating
    Yasunori Matsuda, Masahiro Nishikawa, Satoshi Nishizawa, Yoshinori Yane, Hokuto Ushijima, Taigo Tokuhara
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2019; 29(4): e41.     CrossRef
  • Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse
    Keehoon Hyun, Seo-Gue Yoon
    Annals of Coloproctology.2019; 35(5): 262.     CrossRef
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