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Clin Colon Rectal Surg 2014; 27(04): 182-190
DOI: 10.1055/s-0034-1394157
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Role of Synthetic and Biologic Materials in the Treatment of Pelvic Organ Prolapse

Ramon A. Brown
1   Keesler Medical Center, Keesler Air Force Base, Biloxi, Mississippi
*   The views expressed in this article are those of the authors, and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the U.S. Government.
,
C. Neal Ellis
2   VA Gulf Coast Veterans Health Care System, Biloxi, Mississippi
› Author Affiliations
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Publication History

Publication Date:
10 November 2014 (online)

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Abstract

Pelvic organ prolapse is a significant medical problem that poses a diagnostic and management dilemma. These diseases cause serious morbidity in those affected and treatment is sought for relief of pelvic pain, rectal bleeding, chronic constipation, obstructed defecation, and fecal incontinence. Numerous procedures have been proposed to treat these conditions; however, the search continues as colorectal surgeons attempt to find the procedure that would optimally treat these conditions. The use of prosthetics in the repair of pelvic organ prolapse has become prevalent as the benefits of their use are realized. While advances in biologic mesh and new surgical techniques promise improved functional outcomes with decreased complication rates without de novo symptoms, the debate concerning the best prosthetic material, synthetic or biologic, remains controversial. Furthermore, laparoscopic ventral mesh rectopexy has emerged as a procedure that could potentially fill this role and is rapidly becoming the procedure of choice for the surgical treatment of pelvic organ prolapse.

Keywords

pelvic organ prolapse - ventral mesh rectopexy - biologic mesh
 

  • References

  • 1 Brodén B, Snellman B. Procidentia of the rectum studied with cineradiography. A contribution to the discussion of causative mechanism. Dis Colon Rectum 1968; 11 (5) 330-347
    CrossrefPubMedSearch in Google Scholar
  • 2 Cadeddu F, Sileri P, Grande M, De Luca E, Franceschilli L, Milito G. Focus on abdominal rectopexy for full-thickness rectal prolapse: meta-analysis of literature. Tech Coloproctol 2012; 16 (1) 37-53
    CrossrefPubMedSearch in Google Scholar
  • 3 Cullen J, Rosselli JM, Gurland BH. Ventral rectopexy for rectal prolapse and obstructed defecation. Clin Colon Rectal Surg 2012; 25 (1) 34-36
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Tou S, Brown SR, Malik AI, Nelson RL. Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev 2008; (4) CD001758
    PubMedSearch in Google Scholar
  • 5 Varma M, Rafferty J, Buie WD. Standards Practice Task Force of American Society of Colon and Rectal Surgeons. Practice parameters for the management of rectal prolapse. Dis Colon Rectum 2011; 54 (11) 1339-1346
    CrossrefPubMedSearch in Google Scholar
  • 6 Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patientspecific management strategies. J Gastrointest Surg 2014; 18 (5) 1059-1069
    CrossrefPubMedSearch in Google Scholar
  • 7 Formijne Jonkers HA, van de Haar HJ, Draaisma WA, Heggelman BG, Consten EC, Broeders IA. The optimal strategy for proximal mesh fixation during laparoscopic ventral rectopexy for rectal prolapse: an ex vivo study. Surg Endosc 2012; 26 (8) 2208-2212
    CrossrefPubMedSearch in Google Scholar
  • 8 Laubert T, Kleemann M, Roblick UJ , et al. Obstructive defecation syndrome: 19 years of experience with laparoscopic resection rectopexy. Tech Coloproctol 2013; 17 (3) 307-314
    CrossrefPubMedSearch in Google Scholar
  • 9 Jones OM, Cunningham C, Lindsey I. The assessment and management of rectal prolapse, rectal intussusception, rectocoele, and enterocoele in adults. BMJ 2011; 342: c7099
    CrossrefPubMedSearch in Google Scholar
  • 10 Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 1998; 25 (4) 723-746
    CrossrefPubMedSearch in Google Scholar
  • 11 Chen B, Wen Y, Zhang Z, Wang H, Warrington JA, Polan ML. Menstrual phase-dependent gene expression differences in periurethral vaginal tissue from women with stress incontinence. Am J Obstet Gynecol 2003; 189 (1) 89-97
    CrossrefPubMedSearch in Google Scholar
  • 12 Poncet S, Meyer S, Richard C, Aubert JD, Juillerat-Jeanneret L. The expression and function of the endothelin system in contractile properties of vaginal myofibroblasts of women with uterovaginal prolapse. Am J Obstet Gynecol 2005; 192 (2) 426-432
    CrossrefPubMedSearch in Google Scholar
  • 13 Kerkhof MH, Hendriks L, Brölmann HA. Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20 (4) 461-474
    CrossrefPubMedSearch in Google Scholar
  • 14 Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol 2002; 186 (6) 1160-1166
    CrossrefPubMedSearch in Google Scholar
  • 15 Dietz HP, Wilson PD. Childbirth and pelvic floor trauma. Best Pract Res Clin Obstet Gynaecol 2005; 19 (6) 913-924
    CrossrefPubMedSearch in Google Scholar
  • 16 Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997; 89 (4) 501-506
    CrossrefPubMedSearch in Google Scholar
  • 17 Hiller L, Bradshaw HD, Radley SC, Radley S. A scoring system for the assessment of bowel and lower urinary tract symptoms in women. BJOG 2002; 109 (4) 424-430
    CrossrefPubMedSearch in Google Scholar
  • 18 Hiller L, Radley S, Mann CH , et al. Development and validation of a questionnaire for the assessment of bowel and lower urinary tract symptoms in women. BJOG 2002; 109 (4) 413-423
    CrossrefPubMedSearch in Google Scholar
  • 19 Rutter KRP. Solitary rectal ulcer syndrome; its relation to mucosal prolapse. J Clin Gastroenterol 1985; 4: 505-530
    PubMedSearch in Google Scholar
  • 20 Oettle GJ, Roe AM, Bartolo DC, Mortensen NJ. What is the best way of measuring perineal descent? A comparison of radiographic and clinical methods. Br J Surg 1985; 72 (12) 999-1001
    CrossrefPubMedSearch in Google Scholar
  • 21 Snooks SJ, Setchell M, Swash M, Henry MM. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet 1984; 2 (8402) 546-550
    PubMedSearch in Google Scholar
  • 22 Lubowski DZ, Jones PN, Swash M, Henry MM. Asymmetrical pudendal nerve damage in pelvic floor disorders. Int J Colorectal Dis 1988; 3 (3) 158-160
    CrossrefPubMedSearch in Google Scholar
  • 23 Sullivan ES, Longaker CJ, Lee PYH. Total pelvic mesh repair: a ten-year experience. Dis Colon Rectum 2001; 44 (6) 857-863
    CrossrefPubMedSearch in Google Scholar
  • 24 Lahr SJ, Lahr CJ, Srinivasan A, Clerico ET, Limehouse VM, Serbezov IK. Operative management of severe constipation. Am Surg 1999; 65 (12) 1117-1121 , discussion 1122–1123
    PubMedSearch in Google Scholar
  • 25 Brown AJ, Anderson JH, McKee RF, Finlay IG. Strategy for selection of type of operation for rectal prolapse based on clinical criteria. Dis Colon Rectum 2004; 47 (1) 103-107
    CrossrefPubMedSearch in Google Scholar
  • 26 Formijne Jonkers HA, Draaisma WA, Wexner SD , et al. Evaluation and surgical treatment of rectal prolapse: an international survey. Colorectal Dis 2013; 15 (1) 115-119
    CrossrefPubMedSearch in Google Scholar
  • 27 Senapati A, Gray RG, Middleton LJ , et al; PROSPER Collaborative Group. PROSPER: a randomised comparison of surgical treatments for rectal prolapse. Colorectal Dis 2013; 15 (7) 858-868
    CrossrefPubMedSearch in Google Scholar
  • 28 Kuijpers HC. Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect?. World J Surg 1992; 16 (5) 826-830
    CrossrefPubMedSearch in Google Scholar
  • 29 Smart NJ, Bryan N, Hunt JA. A scientific evidence for the efficacy of biologic implants for soft tissue reconstruction. Colorectal Dis 2012; 14 (3) (Suppl. 03) 1-6
    PubMedSearch in Google Scholar
  • 30 Hübner M, Streit D, Hahnloser D. Biological materials in colorectal surgery: current applications and potential for the future. Colorectal Dis 2012; 14 (3) (Suppl. 03) 34-39
    CrossrefPubMedSearch in Google Scholar
  • 31 Shah BC, Tiwari MM, Goede MR , et al. Not all biologics are equal!. Hernia 2011; 15 (2) 165-171
    CrossrefPubMedSearch in Google Scholar
  • 32 Cornu JN, Peyrat L, Haab F. Update in management of vaginal mesh erosion. Curr Urol Rep 2013; 14 (5) 471-475
    CrossrefPubMedSearch in Google Scholar
  • 33 Birch C. The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obstet Gynaecol 2005; 19 (6) 979-991
    CrossrefPubMedSearch in Google Scholar
  • 34 Huebner M, Hsu Y, Fenner DE. The use of graft materials in vaginal pelvic floor surgery. Int J Gynaecol Obstet 2006; 92 (3) 279-288
    CrossrefPubMedSearch in Google Scholar
  • 35 Baessler K, Maher CF. Mesh augmentation during pelvic-floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 2006; 18 (5) 560-566
    CrossrefPubMedSearch in Google Scholar
  • 36 Mathew MJ, Parmar AK, Reddy PK. Mesh erosion after laparoscopic posterior rectopexy: A rare complication. J Minim Access Surg 2014; 10 (1) 40-41
    CrossrefPubMedSearch in Google Scholar
  • 37 Ahmad M, Sileri P, Franceschilli L, Mercer-Jones M. The role of biologics in pelvic floor surgery. Colorectal Dis 2012; 14 (3) (Suppl. 03) 19-23
    CrossrefPubMedSearch in Google Scholar
  • 38 Smart NJ, Daniels IR. Biologic meshes in colorectal surgery. Colorectal Dis 2012; 14 (3) (Suppl. 03) iii-iv
    CrossrefPubMedSearch in Google Scholar
  • 39 Sileri P, Franceschilli L, de Luca E , et al. Laparoscopic ventral rectopexy for internal rectal prolapse using biological mesh: postoperative and short-term functional results. J Gastrointest Surg 2012; 16 (3) 622-628
    CrossrefPubMedSearch in Google Scholar
  • 40 Smart NJ, Pathak S, Boorman P, Daniels IR. Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy—a systematic review. Colorectal Dis 2013; 15 (6) 650-654
    CrossrefPubMedSearch in Google Scholar
  • 41 Zbar AP, Lienemann A, Fritsch H, Beer-Gabel M, Pescatori M. Rectocele: pathogenesis and surgical management. Int J Colorectal Dis 2003; 18 (5) 369-384
    CrossrefPubMedSearch in Google Scholar
  • 42 Armitage S, Seman EI, Keirse MJ. Use of surgisis for treatment of anterior and posterior vaginal prolapse. Obstet Gynecol Int 2012; 2012: 376251
    PubMedSearch in Google Scholar
  • 43 Frankman EA, Alperin M, Sutkin G, Meyn L, Zyczynski HM. Mesh exposure and associated risk factors in women undergoing transvaginal prolapse repair with mesh. Obstet Gynecol Int 2013; 2013: 926313
    PubMedSearch in Google Scholar
  • 44 Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2010; 18 (4) CD004014
    PubMedSearch in Google Scholar
  • 45 Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 2008; 27 (1) 3-12
    CrossrefPubMedSearch in Google Scholar
  • 46 Maher C, Baessler K. Surgical management of posterior vaginal wall prolapse: an evidence-based literature review. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17 (1) 84-88
    CrossrefPubMedSearch in Google Scholar
  • 47 Bako A, Dhar R. Review of synthetic mesh-related complications in pelvic floor reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20 (1) 103-111
    CrossrefPubMedSearch in Google Scholar
  • 48 Marks BK, Goldman HB. What is the gold standard for posterior vaginal wall prolapse repair: mesh or native tissue?. Curr Urol Rep 2012; 13 (3) 216-221
    CrossrefPubMedSearch in Google Scholar
  • 49 Paraiso MFR, Barber MD, Muir TW, Walters MD. Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol 2006; 195 (6) 1762-1771
    CrossrefPubMedSearch in Google Scholar
  • 50 Kahn MA, Stanton SL, Kumar DA. Randomized prospective trial of posterior colporrhaphy vs transanal repair of rectocele: preliminary findings. Int Urogynecol J 1997; 8: 246-247
    PubMedSearch in Google Scholar
  • 51 Roman H, Michot F. Long-term outcomes of transanal rectocele repair. Dis Colon Rectum 2005; 48 (3) 510-517
    CrossrefPubMedSearch in Google Scholar
  • 52 Ayabaca SM, Zbar AP, Pescatori M. Anal continence after rectocele repair. Dis Colon Rectum 2002; 45 (1) 63-69
    CrossrefPubMedSearch in Google Scholar
  • 53 Watson SJ, Loder PB, Halligan S, Bartram CI, Kamm MA, Phillips RK. Transperineal repair of symptomatic rectocele with Marlex mesh: a clinical, physiological and radiologic assessment of treatment. J Am Coll Surg 1996; 183 (3) 257-261
    PubMedSearch in Google Scholar
  • 54 Ellis CN. Outcomes after the repair of rectoceles with transperineal insertion of a bioprosthetic graft. Dis Colon Rectum 2010; 53 (2) 213-218
    CrossrefPubMedSearch in Google Scholar
  • 55 Altman D, Zetterström J, Mellgren A, Gustafsson C, Anzén B, López A. A three-year prospective assessment of rectocele repair using porcine xenograft. Obstet Gynecol 2006; 107 (1) 59-65
    CrossrefPubMedSearch in Google Scholar
  • 56 Wijffels N, Cunningham C, Dixon A, Greenslade G, Lindsey I. Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete?. Colorectal Dis 2011; 13 (5) 561-566
    CrossrefPubMedSearch in Google Scholar
  • 57 Schiedeck THK, Schwandner O, Scheele J, Farke S, Bruch HP. Rectal prolapse: which surgical option is appropriate?. Langenbecks Arch Surg 2005; 390 (1) 8-14
    CrossrefPubMedSearch in Google Scholar
  • 58 Wahed S, Ahmad M, Mohiuddin K, Katory M, Mercer-Jones M. Short-term results for laparoscopic ventral rectopexy using biological mesh for pelvic organ prolapse. Colorectal Dis 2012; 14 (10) 1242-1247
    CrossrefPubMedSearch in Google Scholar
  • 59 Mantoo S, Podevin J, Regenet N, Rigaud J, Lehur PA, Meurette G. Is robotic-assisted ventral mesh rectopexy superior to laparoscopic ventral mesh rectopexy in the management of obstructed defaecation?. Colorectal Dis 2013; 15 (8) e469-e475
    CrossrefPubMedSearch in Google Scholar
  • 60 Kairaluoma MV, Viljakka MT, Kellokumpu IH. Open vs. laparoscopic surgery for rectal prolapse: a case-controlled study assessing short-term outcome. Dis Colon Rectum 2003; 46 (3) 353-360
    CrossrefPubMedSearch in Google Scholar
  • 61 Cullen J, Rosselli JM, Gurland BH. Ventral rectopexy for rectal prolapse and obstructed defecation. Clin Colon Rectal Surg 2012; 25 (1) 34-36
    Thieme ConnectPubMedSearch in Google Scholar
  • 62 Novell JR, Osborne MJ, Winslet MC, Lewis AAM. Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full-thickness rectal prolapse. Br J Surg 1994; 81 (6) 904-906
    CrossrefPubMedSearch in Google Scholar
  • 63 Wilson J, Engledow A, Crosbie J, Arulampalam T, Motson R. Laparoscopic nonresectional suture rectopexy in the management of full-thickness rectal prolapse: substantive retrospective series. Surg Endosc 2011; 25 (4) 1062-1064
    CrossrefPubMedSearch in Google Scholar
  • 64 Heah SM, Hartley JE, Hurley J, Duthie GS, Monson JRT. Laparoscopic suture rectopexy without resection is effective treatment for full-thickness rectal prolapse. Dis Colon Rectum 2000; 43 (5) 638-643
    CrossrefPubMedSearch in Google Scholar
  • 65 Aitola PT, Hiltunen KM, Matikainen MJ. Functional results of operative treatment of rectal prolapse over an 11-year period: emphasis on transabdominal approach. Dis Colon Rectum 1999; 42 (5) 655-660
    CrossrefPubMedSearch in Google Scholar
  • 66 Luukkonen P, Mikkonen U, Järvinen H. Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis 1992; 7 (4) 219-222
    CrossrefPubMedSearch in Google Scholar
  • 67 Hsu A, Brand MI, Saclarides TJ. Laparoscopic rectopexy without resection: a worthwhile treatment for rectal prolapse in patients without prior constipation. Am Surg 2007; 73 (9) 858-861
    PubMedSearch in Google Scholar
  • 68 Sahoo MR, Thimmegowda AK, Gowda MS. A single centre comparative study of laparoscopic mesh rectopexy versus suture rectopexy. J Minim Access Surg 2014; 10 (1) 18-22
    CrossrefPubMedSearch in Google Scholar
  • 69 Athanasiadis S, Weyand G, Heiligers J, Heumüller L, Barthelmes L. The risk of infection of three synthetic materials used in rectopexy with or without colonic resection for rectal prolapse. Int J Colorectal Dis 1996; 11 (1) 42-44
    CrossrefPubMedSearch in Google Scholar
  • 70 Visco AG, Weidner AC, Barber MD , et al. Vaginal mesh erosion after abdominal sacral colpopexy. Am J Obstet Gynecol 2001; 184 (3) 297-302
    CrossrefPubMedSearch in Google Scholar
  • 71 Iglesia CB, Fenner DE, Brubaker L. The use of mesh in gynecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct 1997; 8 (2) 105-115
    CrossrefPubMedSearch in Google Scholar
  • 72 Ellis C. Functional outcomes with a total pelvic mesh repair using bioprosthetics for management of pelvic floor prolapse. Dis Colon Rectum 2011; 54: 5
    PubMedSearch in Google Scholar
  • 73 D'Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 2004; 91 (11) 1500-1505
    CrossrefPubMedSearch in Google Scholar
  • 74 Wong M, Meurette G, Abet E, Podevin J, Lehur PA. Safety and efficacy of laparoscopic ventral mesh rectopexy for complex rectocele. Colorectal Dis 2011; 13 (9) 1019-1023
    CrossrefPubMedSearch in Google Scholar
  • 75 D'Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc 2006; 20 (12) 1919-1923
    CrossrefPubMedSearch in Google Scholar
  • 76 Sileri P, Capuano I, Franceschilli L, Giorgi F, Gaspari AL. Modified laparoscopic ventral mesh rectopexy. Tech Coloproctol 2014; 18 (6) 591-594
    CrossrefPubMedSearch in Google Scholar
  • 77 Portier G, Kirzin S, Cabarrot P, Queralto M, Lazorthes F. The effect of abdominal ventral rectopexy on faecal incontinence and constipation in patients with internal intra-anal rectal intussusception. Colorectal Dis 2011; 13 (8) 914-917
    CrossrefPubMedSearch in Google Scholar
  • 78 D'Hoore A, Vanbeckevoort D, Penninckx F. Clinical, physiological and radiological assessment of rectovaginal septum reinforcement with mesh for complex rectocele. Br J Surg 2008; 95 (10) 1264-1272
    CrossrefPubMedSearch in Google Scholar
  • 79 Samaranayake CB, Luo C, Plank AW, Merrie AEH, Plank LD, Bissett IP. Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis 2010; 12 (6) 504-512
    PubMedSearch in Google Scholar
  • 80 Mercer-Jones MA, D'Hoore A, Dixon AR , et al. Consensus on ventral rectopexy: report of a panel of experts. Colorectal Dis 2014; 16 (2) 82-88
    CrossrefPubMedSearch in Google Scholar