SRS379 - Is bowel retraining imperative for good anatomic and functional outcomes in patients undergoing ventral mesh rectopexy for full-thickness rectal prolapse?

Abstract Introduction Ventral mesh rectopexy (VMR) is gaining popularity for the repair of full-thickness rectal prolapse. Peri-operative bowel function retraining (BFR) has shown to improve functional outcomes in rectal prolapse patients. The aim was to determine the impact of BFR on recurrence in patients undergoing VMR. Methods Data was collected retrospectively between 2012 and 2022 for demographics, ASA, type of prolapse (low versus high take-off), surgical approach (laparoscopic versus robotic), number of peri-operative BFR sessions, post-operative follow-up, complications, and recurrence. Results VMR was performed in 84 patients with female dominance (90%). Twenty-nine patients presented with a recurrent rectal prolapse, and eight underwent a joint procedure with Urogynaecology. Median length of follow-up was 626 days. BFR sessions were attended by 51 (61%) patients before and 44 (52%) after surgery. Complications were reported in 8 patients. Recurrence was seen in 17 (23.9%) patients at a median duration of 487 days. No association was established between rectal prolapse recurrence and gender, previous pelvic floor or rectal prolapse surgery, and surgical approach. Furthermore, BFR programme participation either pre- or post-operatively did not demonstrate a measurable effect on recurrence rates. Conclusions VMR for rectal prolapse repair has acceptable morbidity with a 24% recurrence rate. Recurrence is independent of previous rectal prolapse repairs. In this study, peri-operative BFR has not shown to reduce recurrence. Future prospective studies are needed to explore risk factors for recurrence and to ascertain if correction of pelvic floor function via BFR is crucial to good anatomic and functional outcomes after VMR.