Annals of Coloproctology

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Original Article

Anorectal physiology & pelvic floor disorder

Laparoscopic ventral mesh rectopexy with and without transverse perineal support using biological mesh for rectal prolapse and perineal descent: postoperative course and functional outcomes: Maria Clelia Gervasi, Giorgio Brancato, Lorenzo Crepaz, Ahmad Tfaily, Alberto Di Leo; Ann Coloproctol. 2025;41(5):453-461. Published online October 28, 2025; DOI: https://doi.org/10.3393/ac.2025.00080.0011

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Purpose
Laparoscopic ventral mesh rectopexy (LVMR) is effective for the treatment of rectal prolapse. However, descending perineal syndrome may impair the outcomes of LVMR. The aim of this study was to assess the safety and functional outcomes of LVMR performed with and without transverse perineal support (TPS).
Methods
This was a retrospective study of 143 consecutive female patients treated with LVMR with or without TPS between 2018 and 2022. Patients with rectal prolapse and perineal descent who underwent surgery were included. Obstructed defecation syndrome and fecal incontinence were evaluated using the Cleveland Constipation Score (Wexner score) and St. Mark’s Incontinence Score, respectively. Perineal descent was defined using defecography. Biological meshes were utilized in all cases.
Results
No significant differences were recorded between with- and without-TPS groups at baseline. TPS was performed in 110 patients (76.9%). Surgical morbidity was higher in the with-TPS group (12.7% vs. 0%, P=0.047), primarily due to seroma formation. Almost all complications were mild (Clavien-Dindo grades I–II). In both groups, digital aid for defecation (P<0.001), prolonged straining (P=0.004), and hematochezia (P<0.001) nearly disappeared postoperatively, though constipation and laxative/enema use persisted in 22.4%. Fecal incontinence significantly decreased from 43.4% to 11.2% (P<0.001). TPS appears to have a potentially favorable effect in reducing the constipation score. Both constipation and incontinence scores remained low up to 24 months after surgery. Operative time was significantly longer in the LVMR with-TPS group (P<0.001).
Conclusion
LVMR with TPS appears safe and feasible. TPS may provide better surgical outcomes compared to LVMR alone for patients with symptomatic rectoceles and descending perineum syndrome.

Citations

Citations to this article as recorded by

Beyond stapled transanal rectal resection vs ventral rectopexy dichotomy: Toward a phenotype-guided surgical paradigm for obstructed defecation syndrome
Michele Schiano di Visconte, Sonia Sarnari
World Journal of Gastrointestinal Surgery.2026;[Epub] CrossRef

Case Report

Benign GI diease,Complication

Transmural Mesh Migration From the Abdominal Wall to the Rectum After Hernia Repair Using a Prolene Mesh: A Case Report: Yujin Lee, Byung-Noe Bae; Ann Coloproctol. 2021;37(Suppl 1):S28-S33. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.19

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8 Web of Science
9 Citations

Abstract PDF

Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore, the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh (Ethicon) from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.

Citations

Citations to this article as recorded by

Validation of a rat parastomal hernia model for evaluating mesh biocompatibility and repair outcomes
Xiaoqiang Zhu, Jiajie Liu, Jianfeng Shen, Nan Liu, Mingan Zhong, Rui Tang
Hernia.2026;[Epub] CrossRef
Clinical Insights and Brief Research Report on Mesh Erosion Into Bowel Following Hernia Repair: A Single-Centre Series of Eight Cases
Vidit Dholakia, Suvendu Sekhar Jena, Amitabh Yadav, Samiran Nundy
Journal of Abdominal Wall Surgery.2025;[Epub] CrossRef
An unlikely path: hernia mesh migration
Ana Rita Ferreira, Bárbara Castro, Catarina Ortigosa, Sílvia Costa, Bela Pereira, Manuel Oliveira
European Surgery.2024; 56(1-2): 39. CrossRef
Spontaneous Migration of Intraperitoneal Mesh into Rectum following Ventral Hernia Repair
Aruna R. Patil, Ravishankar Bhat, Madhusudhana Basavarajappa
Journal of Gastrointestinal and Abdominal Radiology.2023; 06(01): 053. CrossRef
Gastrocutaneous fistula caused by mesh migration following diaphragmatic rupture repair
Yuan Zhang, Jun Peng, Xingui Wu, Dingjiao Zhu, Yaozhi Chen
ANZ Journal of Surgery.2023; 93(4): 1042. CrossRef
Enterocutaneous fistula from a mesh eroding the small bowel after incisional hernia repair
Michael L. Lorentziadis, Moustafa Mahmoud Nafady Hego, Fatma Al Nasser
International Journal of Abdominal Wall and Hernia Surgery.2023; 6(1): 48. CrossRef
Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis
Théophile Delorme, Jonathan Cottenet, Fawaz Abo-Alhassan, Alain Bernard, Pablo Ortega-Deballon, Catherine Quantin
Hernia.2023; 28(2): 419. CrossRef
A Cecal Surprise
Muhammad B. Hammami, Jean-Pierre Raufman
Gastroenterology.2022; 162(7): 1847. CrossRef
Mesh on the move: a case report of total transmural surgical mesh migration causing bowel obstruction
Joseph Ryan Leach, Bryan Manoukian, Lygia Stewart
Clinical Journal of Gastroenterology.2021; 14(1): 136. CrossRef

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