Functional and surgical outcomes of ventral mesh rectopexy in male patients with rectal prolapse: a nationwide multicenter retrospective cohort study by the Pelvic Floor Working Group of the Turkish Society of Colon and Rectal Surgery (TSCRS)

BACKGROUND: The indications and outcomes of ventral mesh rectopexy (VMR) in the treatment of rectal prolapse in males have been minimally addressed in the literature. This study aimed to evaluate the demographics, clinical characteristics, and surgical outcomes associated with VMR in male patients. METHODS: This nationwide retrospective cohort study included male patients who underwent VMR at centers performing pelvic floor surgery across Turkey. Clinical and surgical characteristics were obtained, and functional outcomes were evaluated using Cleveland Clinic Incontinence score (CCIS) and Altomare Obstructed Defecation Syndrome (ODS) scores at the pre- and postoperative periods. RESULTS: ) underwent VMR (2 open, 5 robotic, and 34 laparoscopic). The cohort comprised 11 patients with internal rectal prolapse (IRP) and 30 with external rectal prolapse (ERP). The overall complication rate was 17.1% (2.4% related to mesh), with a 12% recurrence rate. The median follow-up was 33 (6-127) months. The recurrence rate was 36.4% for IRP patients and 3.3% for ERP patients (p = 0.014). Significant improvements were observed in the CCIS (preoperative: 6.1 ± 4.8; postoperative: 2.8 ± 3.3, p = 0.005) and Altomare ODS (preoperative: 11.9 ± 4.6; postoperative: 7.26 ± 5.8, p < 0.001). CONCLUSIONS: In this nationwide retrospective cohort study, VMR was associated with favorable functional outcomes in males. Recurrence rates were significantly higher in those with internal rectal prolapse. As sexual function was not systematically assessed, prospective studies with standardized patient-reported outcomes are warranted.