Role of Levatorplasty in Management of Rectal Prolapse in Patients with Wide Pelvic Hiatus

Abstract Purpose Rectal prolapse (RP) is a debilitating condition associated with symptoms such as fecal incontinence, obstructed defecation, incomplete rectal evacuation, and significant discomfort. Recent evidence highlights the strong correlation between prolapse development and the size of the pelvic hiatus (GH). Surgical studies have suggested a potential link between an enlarged pelvic hiatus and prolapse recurrence. This study aims to evaluate recurrence rates in patients with rectal prolapse characterized by a wide pelvic hiatus who underwent surgical management. Methods In this prospective cohort study, 60 patients with rectal prolapse and a wide pelvic hiatus were divided into two groups, each comprising 30 patients. One group underwent rectal prolapse repair, while the other group underwent rectal prolapse repair with levatorplasty. Results The levatorplasty group exhibited notable improvements in Wexner scores and lower recurrence rates compared to the other group. Both groups demonstrated similar outcomes in terms of postoperative pain and dyspareunia. Conclusion Rectal prolapse repair combined with levatorplasty represents an effective approach for patients presenting with rectal prolapse and a wide pelvic hiatus. This combination results in improved Wexner scores and reduced recurrence rates, providing valuable insights into the management of this challenging condition.