A rare case of advanced pelvic organ prolapse concurrent with high-grade rectal prolapse: A case report

一例罕见的晚期盆腔器官脱垂合并重度直肠脱垂病例报告

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Abstract

RATIONALE: Concurrent pelvic organ prolapse (POP) and rectal prolapse is a rare condition that poses significant therapeutic challenges. A customized, multidisciplinary strategy is frequently required, particularly in complex cases with underlying functional deficits. PATIENT CONCERNS: A 71-year-old woman presented with stage III POP and grade V rectal prolapse. Her history included no pregnancies or vaginal intercourse, and she previously underwent sacral tumor excision resulting in anal and urinary incontinence, requiring long-term catheterization. DIAGNOSES: Preoperative clinical examination and imaging (transabdominal and transvaginal ultrasound) confirmed the diagnosis of stage III POP and grade V rectal prolapse. Routine blood tests, vaginal bacteriological cultures, and Pap smear were unremarkable. INTERVENTIONS: The patient underwent a multidisciplinary surgical procedure including hysterectomy, sacrocolpopexy, and rectopexy using a Pro-Grip™ self-fixating mesh. The mesh was placed to anchor the vaginal stump and provide rectal support simultaneously. OUTCOMES: The patient had an uneventful recovery, with drain removal on postoperative day 5 and discharge on day 7. Follow-up at 3 months, 6 months, and 1 year showed no recurrence of prolapse. The patient declined additional imaging at 1 year, considering herself fully recovered. LESSONS: This case demonstrates that a self-fixating mesh can provide effective concurrent repair of POP and rectal prolapse in a single procedure. Short-term outcomes were favorable, but long-term follow-up remains essential to assess durability and potential complications.

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