Abstract
Ventral mesh rectopexy (VMR) is a recognized treatment for posterior compartment pelvic organ prolapse (POP). The aim of this review is to provide a synopsis of the evidence for biological mesh use in VMR, the most widely recognized surgical technique for posterior compartment POP. A systematic search of PubMed was conducted using the search terms "VMR," "ventral mesh rectopexy," or "mesh rectopexy." Six studies were identified. About 268/324 patients underwent ventral rectopexy using biological mesh with a further 6 patients having a combination of synthetic and biological mesh. Recurrence was reported in 20 patients; however, 6 were from studies where data on biological mesh could not be extracted. There are no RCTs in VMR surgery and no studies have directly compared types of biological mesh. Cross-linked porcine dermal collagen is the most commonly used mesh and has not been associated with mesh erosion, infection, or fistulation in this review. The level of evidence available on the use of biological mesh in VMR is of low quality (level 4). Ventral mesh rectopexy has become prevalent for posterior compartment POP. The evidence base for its implementation is not strong and the quality of evidence to inform choice of mesh is poor.
Highlights
Ventral mesh rectopexy (VMR) is a recognized treatment for posterior compartment pelvic organ prolapse (POP)
Recurrence was reported in 20 patients; 6 of these were from studies where data on biological mesh could not be extracted
The level of evidence available on the use of biological mesh in VMR is of low quality [13]
Summary
Ventral mesh rectopexy (VMR) is a recognized treatment for posterior compartment pelvic organ prolapse (POP). It is believed to address functional bowel symptoms by providing suspensory support to the prolapsing organ (in this case the rectum ± the vaginal vault) and avoiding the autonomic denervation that results in de novo symptomatology. It improves obstructive defaecatory symptoms as well as symptoms of incontinence [1,2,3,4] without initiating significant new onset constipation [1, 5]. VMR has rapidly established itself in Europe as the procedure of choice for posterior compartment POP in spite of a limited evidence base
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