FOAM: Functional Outcome After Ventral Mesh Rectopexy

FOAM: Functional Outcome After Ventral Mesh Rectopexy, Prospective Cohort Study

Rectal prolapse is a protrusion of rectal wall through the anus. A surgical technique called Ventral mesh rectopexy has become a standard procedure for this condition in many centers.

The goal of this trial is to investigate functional outcome, recurrence rates and complications after ventral mesh rectopexy. The main question it aims to answer is:

- Do bowel function, quality of life and sexual function improve after Ventral mesh rectopexy?

Participants will:

• be asked to fill in questionaires before surgery, 3-6 months after surgery and 12 months after surgery.
• be examined by a surgeon 3-6 months, 12 months and 3 years after surgery.

Several different procedures have been described for surgical treatment of rectal prolapse and a consensus has not yet been reached. Over the past 20 years, the use of Ventral mesh rectopexy to treat external rectal prolapse has gained increasing worldwide acceptance. Ventral mesh rectopexy has become a standard procedure in many centers based on low recurrence rates, limited complications and good functional results but the use and type of mesh have been debated. Concerns have also been expressed regarding the choice of surgical technique, which differs between centers, and the lack of high-level evidence.

There are few prospective trials and the use of LVMR in a Swedish setting has not yet been evaluated. FOAM (Functional Outcome After ventral Mesh rectopexy) therefore aims to investigate bowel function, quality of life, sexual function, recurrence rates and complications after ventral mesh rectopexy.

A prospective cohort study on patients undergoing ventral mesh rectopexy for external rectal prolapse in Sweden will be conducted. Approximately 70 patients will be included at a maximum of 10 hospitals in Sweden.

Inclusion Criteria:

• full-thickness rectal prolapse
• the surgeon agrees that ventral mesh rectopexy is needed for the condition
• capable of participating in follow-up visits and answering questionnaires
• informed consent

Exclusion Criteria:

• patient below 18 years of age
• ongoing pregnancy
• inability to understand the Swedish language
• dementia or other cognitive disorder that unables informed consent