Obstructed Defecation Syndrome: analysis of the efficacy and mid-term quality of life of an innovative robotic approach

Abstract

Aim The aim of our study is to prove how the combination of the Rectal wall Plication (RP) and the association with robotic Ventral Mesh Rectopexy (VMR) would result in a safe and effective procedure for patients with Obstructed Defecation Syndrome (ODS) and would provide better outcomes in terms of bowel function and Quality of Life. Methods From January 2018 to December 2021, 78 women affected by ODS and posterior compartment prolapse were enrolled for the study. The minimum follow-up for these patients were 18 months. 30 patients underwent VMR and 33 VMR plus RP. The primary endpoint was to evaluate the effectiveness and the safety of VMR and VMR + RP at median follow-up.The secondary endpoint was to evaluate the impact on quality of life and sexual function of these two surgical procedures. Results In symptomatic evaluation and analysis of post-operative complications ,at the median follow-up, 6 patients (20%) in VMR group vs 1 patient (3%) in VMR+RP group still had constipation (p=0.023). In the VMR+RP group, the number of sexually active patients after surgery and the PISQ-12 results showed an improvement in the quality of sexual life after at least 18 months of follow up. Finally, at the median follow-up the ODS score values were significantly reduced in both groups Conclusion Although long-term f-u and a larger group of pats. is required, the findings we have acquired are encouraging and allowed us to say that in pats with ODS and posterior compartment prolapse the combination of rectal wall plication and ventral mesh rectopexy may improve results in terms of bowel function and quality of life.