Traitement de la rectocèle par une prothèse biologique de derme porcin inter-rectovaginale associé à une sacropexie infracoccygienne

Abstract

To evaluate an infracoccygeal colpopexy procedure by tension-free synthetic tape for vaginal apical prolapse associated with a posterior mesh procedure using porcine dermal graft for rectocele repair. A retrospective study concerning 35 women. The surgical procedure included rectocele repair with porcine dermal collagen implant (porcine dermal matrix, native) associated with transgluteal infracoccygeal sacropexy using a polypropylene sling. Median follow up was 48 months (42-54). A vaginal hysterectomy was associated in 43% and a cure of cystocele was associated in 63% of cases. No intra-operative complication was noted. The prevalence of dyschesia decreased from 25% (eight patients) preoperatively to 3% (one patient) postoperatively. No cases of de novo dyspareunia was noted. Five (14%) patients had a recurrent prolapse (two cases of rectocele stage 2, one case of grade 3 rectocele associated with a cystocele, a case of uterine prolapse associated with cystocele and one case of recurrent isolated uterine prolapse). Among them, three patients (9%) required a re-intervention for prolapse recurrence. No vaginal mesh exposure was observed. Perineal pain was reported by 12 (33%) patients at one month follow-up, but no patient complained with perineal pain one year follow-up. Infracoccygeal sacropexy associated with rectocele repair using porcine dermal collagen implant was associated with satisfactory results at medium term follow-up.