EP909 - Incidence of sigmoid diverticulitis before and after ventral mesh rectopexy

Tuesday, May 13, 2025

8:10 AM – 8:15 AM PT

ePoster Presenter(s)

Yaniv Zager, MD

Colorectal Fellow
Advent Health Orlando
Orlando, Florida, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Anastasiya Shchatsko, MD

fellow
AdventHealth Orlando
Orlando, FL, United States

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This individual has no financial relationships with ineligible companies.
Saba Balvardi, MD (she/her/hers)

Colorectal Surgery Fellow
AdventHealth Medical Group Colorectal Surgery
Orlando, FL, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
MA

Michael Abdelmasseh, n/a

Research Fellow
Adventhealth
Orlando, Florida, United States

Disclosure information not submitted.
Daniel J. Galante, n/a

Colorectal Surgeon
Adventhealth
Loma Linda University, University of Central Florida
Orlando, Florida, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
JD

Jeremy Drake, n/a

Colorectal Surgeon
Adventhealth
Orlando, Florida, United States

Disclosure information not submitted.
Mark Soliman, MD, FACS, FASCRS

Medical Director of Colorectal Surgery for the AdventHealth Digestive Health and Surgery Institute
AdventHealth
University of Central Florida
Orlando, Florida, United States

Disclosure information not submitted.

Senior Author(s)

Td

Teresa deBeche-Adams, MD

Colorectal Surgeon, Division Chair
AdventHealth
Orlando, Florida, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Yaniv Zager, MD: This individual has no financial relationships with ineligible companies.

Anastasiya Shchatsko, MD: This individual has no financial relationships with ineligible companies.

Saba Balvardi, MD: This individual has no financial relationships with ineligible companies.

Daniel J. Galante, n/a: This individual has no financial relationships with ineligible companies.

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Purpose/Background: Sigmoid diverticulitis is a common cause of acute abdomen. Its pathophysiology involves micro or macro perforation of diverticula. In some cases, an emergent or elective surgery are indicated. Ventral Mesh Rectopexy (VMR) is, nowadays, the surgical gold standard for rectal prolapse, obstructed defecation syndrome (ODS) and part of surgical treatment for other pelvic floor dysfunction conditions. While surgeons often encounter patients needing treatment for both diverticulitis and pelvic floor disorders, there is limited literature on this overlap. This study aims to evaluate the incidence of patients presenting with both conditions either synchronously or metachronously.

Methods/Interventions: Retrospective study done in large healthcare system in central Florida, USA. The registry of patients that underwent VMR was reviewed for diagnosis of diverticulitis before and after VMR as well as presence of diverticulosis in colonoscopy, Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI). Descriptive statistics were done using SPSS version 21 (IBM). Date presented in percents, means and standard deviations.

Results/Outcomes: We reviewed the details of 286 pelvic floor reconstruction procedures that included VMR. All patients were female. The average patients' age was 63±12 years. The Average Body Mass Index (BMI) was 27.54±5.06. Sixty-six (38.6%) of the patients had evidence of sigmoid/descending colon diverticulosis in imaging/endoscopy.
Four patients (1.4%) had sigmoid diverticulitis prior to VMR procedure. Of them three (75%) underwent sigmoid resection prior to VMR. In one case, after reviewing imaging, the diagnosis was changed to colitis and the patient underwent VMR without prior sigmoidectomy. One of the patients that underwent sigmoidectomy before VMR, had recurrent diverticulitis and constipation after the VMR. Three patient (0.01%) had sigmoid diverticulitis after undergoing VMR. During the time of follow-up, none of them underwent sigmoidectomy for diverticulitis.

Conclusion/Discussion: Although the rate of diverticulosis in patients undergoing Ventral Mesh Rectopexy (VMR) appears to be lower than that of the general population, sigmoid diverticulitis can still occur. Prospective studies are warranted to better evaluate the common incidence of diverticulitis and pelvic floor dysfunction, as well as reviewing and analyzing surgeons' clinical decisions making in those situations.