Sacrocolporectopexy for Triple Compartment Prolapse: Improving Quality of Life in Women with Pelvic Floor Dysfunction

Triple compartment prolapse is a significant health issue affecting women, characterized by the downward movement of pelvic organs. In the Indian population, factors such as multiparity, aging, and cultural practices contribute to a high prevalence of pelvic floor dysfunction. Constipation affects approximately 16.8% of Indians, with women being more severely impacted. Traditional treatment approaches have often focused on individual compartments, leading to suboptimal outcomes. This study aimed to evaluate the improvement in quality of life following sacrocolporectopexy. This hospital-based observational study was conducted over 2.5 years, involving 35 patients with multiple pelvic organ prolapse. Patients underwent detailed investigations, including visual inspection, rectovaginal examination, and neuromuscular exam. MR defecography and anorectal manometry confirmed triple compartment descent. Patients completed validated questionnaires (Patient Assessment of Constipation Symptom Questionnaire and Fecal Incontinence Severity Index) pre-operatively and at 1 and 6 months post-surgery. Significant improvements were observed in both constipation and fecal incontinence symptoms. The mean PAC-SYM score decreased from 16.37 pre-operatively to 4.31 at 6 months post-surgery (p < 0.001). Similarly, the FISI score improved from 8.31 to 0.91 during the same period (p < 0.001). Patient satisfaction was high, with 89% reporting satisfaction with the procedure. The average hospital stay was 7.54 days. Most patients had comorbidities, with hypertension being most prevalent, and 28.57% had a history of hysterectomy. In conclusion, sacrocolporectopexy proves to be an effective surgical intervention for addressing pelvic organ prolapse and associated bowel dysfunction, significantly improving patients' quality of life and symptom management.