Version July 2025
| Description | Comments | |
| Ventral mesh rectopexy | Mobilize the rectum anteriorly, suture the rectum to a mesh, and suspend the mesh to the sacral promontory. | Ventral mesh rectopexy typically does not cause constipation as frequently and can correct concomitant anterior compartment prolapse. |
| Posterior rectopexy | Mobilizing the rectum posteriorly or both posteriorly and anteriorly. The lateral stalks are preserved to avoid constipation except in patients with fecal incontinence. This is followed by fixation of the rectum to the sacrum promontory with sutures or mesh. | Posterior rectopexy can cause constipation. Thus, it is avoided in patients with pre-existing constipation and is preferred in patients with baseline fecal incontinence. |
| Resection rectopexy | Mobilizing the sigmoid colon and rectum, resect a segment of the sigmoid colon, anastomose the remaining colon to the rectum, and suture the rectum to the sacral promontory. | Sigmoid resection is only indicated in patients with prior constipation. It is contraindicated in patients with a prior failed perineal rectosigmoidectomy. |
