Laparoscopic sacrocolpopexy with ventral rectopexy for concomitant pelvic organ and rectal prolapse following anorectoplasty for imperforate anus: A case report.

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  • 鎖肛術後の骨盤臓器脱合併直腸脱に対しLaparoscopic Sacrocolpopexy with Ventral Rectopexy を施行した1 例

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Abstract

<p>A 49-year-old female (gravida 2, para (vaginal) 2) with a history of anorectoplasty for imperforate anus was referred to our department for surgical treatment for pelvic organ prolapse and rectal prolapse. She was born with imperforate anus and underwent surgery for colostomy followed by anorectoplasty in infant, and colostomy reversal at the age of five (surgical records were not available). Considering the era of her newborn period and her surgical scars which observed in the flank (stoma) and sacrococcygeal area, we speculated she underwent Stephens’ procedure for imperforate anus.</p><p>She also had a symptomatic 13 cm myoma-uteri, and laparoscopic pelvic surgery would be feasible because Stephens’ procedure means retro-rectal approach with minimal insult to abdominal cavity and recto-vaginal septum. Therefore, we planned and successfully performed concomitant laparoscopic sacrocolpopexy, ventral rectopexy, supracervical hysterectomy and recto-anal mucosectomy/mucopexy.</p><p>The postoperative course was uneventful and she discharged 3 days after the surgery with a pleasure for improvement of fecal incontinence and dry perineal area. And now, 12 months after the surgery, no recurrences or functional disturbances were observed.</p>

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