Short-Term Complications of Concomitant Pelvic Organ Prolapse and Rectal Prolapse Repair: A Systematic Review and Meta-Analysis.

Abstract

The objective was to evaluate and compare the short-term postoperative complications of concomitant pelvic organ prolapse (POP) and rectal prolapse repair with isolated apical prolapse repair or rectopexy. This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed using Web of Science, PubMed, Embase, and Scopus for studies published up to April 2024. Studies included were retrospective case-control studies, clinical cohort studies, and randomized clinical trials comparing short-term complications between concomitant apical and rectal prolapse repairs versus isolated repairs. A total of seven studies, encompassing 16,471 patients, met the inclusion criteria. Of these, 843 patients underwent concomitant surgery, 7,808 underwent apical prolapse repair alone, and 7,820 underwent rectopexy alone. The meta-analysis revealed no significant increase in the overall complication rate for the concomitant group compared with the apical prolapse alone (OR 0.78; 95% CI 0.56, 1.09; p = 0.14; I2 = 0%) or rectopexy alone (OR 0.79; 95% CI 0.49, 1.25; p = 0.31; I2 = 48%). Furthermore, serious complication rates were not significantly higher in the concomitant group compared with isolated apical prolapse repair (OR 0.70; 95% CI 0.43, 1.16; p = 0.16; I2 = 0%) or rectopexy alone (OR 0.86; 95% CI 0.54, 1.35; p = 0.50; I2 = 39%). Concomitant apical and rectal prolapse repair does not significantly increase the risk of short-term postoperative complications compared with isolated repairs. This approach appears safe and feasible, suggesting that combined surgeries might offer a comprehensive treatment for patients with multicompartmental prolapse without elevating operative risks.