Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition

Objective To assess the sacrocolpopexy with mesh interposition in women wit h pelvic organ pi-elapse. A prospective study. Tertiary referral urogynaeco logy and pelvic floor reconstruction unit. Design A prospective study Setting Tertiary referral urogynarculugy and pelvic. floor reconstruction u nit. Population Twenty-nine consecutive women with symptomatic vault prolapse an d rectocele. Main outcome measures Subjective and objective success rates and complicati ons. Results The mean age was 57 years. The mean number of past prolapse operati ons was 2.6 which included two past sacrospinous ligament fixations and 17 past posterior repairs. The mean follow up was 14 months. There was an incr ease in constipation from 41% to 50%, a decrease in faecal soiling from 21% to 10%, and an increase in incomplete defecation from 24% to 35%. Dyspareu nia decreased from 38% to 17%, and there was some improvement in the stress and urge incontinence. There was a significant reduction of vault prolapse and rectocele (P < 0.001). All women with Stage II and Stage III vault pro lapse were corrected, with an increase in Stage I prolapse from 20% to 27%. All women with Stags II and Stage III rectocele were corrected with a decr ease in Stage I prolapse from 36% to 7%. The only significant interoperativ e complication was a cystotomy. One mesh became infected post-operatively w hich required removal. Conclusions Sacrocolpopexy and mesh interposition is a safe and reliable op eration for the correction of vault prolapse and rectocele. A long term fol low up is necessary to detect any late complications.