{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:07:07Z","timestamp":1784635627278,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Concomitant pelvic organ prolapse (POP) and rectal prolapse (RP) is a relatively rare and often underrecognized clinical condition, typically managed as two separate entities within a single-disciplinary framework. Historically, transvaginal mesh (TVM), although widely used in pelvic floor reconstruction, has not been applied to treat RP. We report a 76-year-old female with severe POP and concomitant RP. Guided by the integral theory of pelvic floor, we innovatively cut and assembled TiLOOP Total 4 mesh into Total 6 configuration, connected it to a trimmed TiLOOP mesh (10\u2009\u00d7\u200915\u2005cm), and performed transvaginal fixation of the anterior rectal wall using the mesh during TVM pelvic floor reconstruction. This modified TVM pelvic floor reconstruction with concurrent TVM rectopexy achieved unexpectedly favorable outcomes, with no recurrence or mesh-related complications at 18 months of follow-up.Our findings suggest that, in selected cases meeting the indications, combined TVM pelvic floor reconstruction with concurrent TVM rectopexy appears to be feasible and may represent a potential effective treatment option for colorectal and gynecologic surgeons managing concurrent POP and RP. It should be noted, however, that this is a single case report with limited sample size, no control group, and short-term follow-up. Future studies with cohort designs or extended follow-up are warranted to further validate the efficacy of this procedure.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1873845","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:54:01Z","timestamp":1784634841000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transvaginal single-pathway composite reconstruction for pelvic organ prolapse combined with rectal prolapse: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Xi","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine)","place":["Zhuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine)","place":["Zhuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neng Jing","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine)","place":["Zhuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine)","place":["Zhuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangshi","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Second Xiang ya Hospital of Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Sha","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine)","place":["Zhuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"975829","DOI":"10.3389\/fpubh.2022.975829","article-title":"Global burden and trends of pelvic organ prolapse associated with aging women: an observational trend study from 1990 to 2019","volume":"10","author":"Wang","year":"2022","journal-title":"Front Public Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1007\/s00192-021-04875-y","article-title":"International urogynecological consultation: clinical definition of pelvic organ prolapse","volume":"32","author":"Collins","year":"2021","journal-title":"Int Urogynecol J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1007\/s00192-021-04826-7","article-title":"The distribution of pelvic organ support defects in women undergoing pelvic organ prolapse surgery and compartment specific risk factors","volume":"33","author":"Payebto Zoua","year":"2022","journal-title":"Int Urogynecol J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"188","DOI":"10.33878\/2073-7556-2025-24-4-188-200","article-title":"Rectocele in females: unresolved issues (review)","volume":"24","author":"Metrinsky","year":"2025","journal-title":"Koloproktologia"},{"key":"B5","doi-asserted-by":"publisher","first-page":"601","DOI":"10.26442\/20795696.2021.6.201287","article-title":"Pathogenesis of vaginal prolapse with the formation of rectocele: a review","volume":"23","author":"Radzinsky","year":"2021","journal-title":"Gynecology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1097\/DCR.0000000000000889","article-title":"Clinical practice guidelines for the treatment of rectal prolapse","volume":"60","author":"Bordeianou","year":"2017","journal-title":"Dis Colon Rectum"},{"key":"B7","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.urology.2020.05.010","article-title":"Trends in the diagnosis and management of combined rectal and vaginal pelvic organ prolapse","volume":"150","author":"Speed","year":"2021","journal-title":"Urology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1055\/s-0045-1804514","article-title":"Ways to repair multicompartment prolapse: decision-making and surgical approach","volume":"38","author":"Rahman","year":"2025","journal-title":"Clin Colon Rectal Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"502","DOI":"10.21614\/chirurgia.3210","article-title":"Concurrent pelvic organ and rectal prolapse: a narrative review of surgical perspectives","volume":"120","author":"Botoncea","year":"2025","journal-title":"Chirurgia (Bucur)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000000819.010","article-title":"MP05-10 accuracy of Media coverage about the 2019 US food and drug administration ban on transvaginal mesh for pelvic organ prolapse","volume":"203","author":"Ray","year":"2020","journal-title":"J Urol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/siuj6010002","article-title":"Synthetic meshes in pelvic organ prolapse: a narrative review","volume":"6","author":"Lasri","year":"2025","journal-title":"Soci\u00e9t\u00e9 Internationale d\u2019Urologie Journal"},{"key":"B12","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1002\/ijgo.12932","article-title":"FIGO urogynecology and pelvic floor committee. FIGO review of statements on use of synthetic mesh for pelvic organ prolapse and stress urinary incontinence","volume":"147","author":"Ugianskiene","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"key":"B13","year":""},{"key":"B14","doi-asserted-by":"publisher","first-page":"831285","DOI":"10.1155\/2015\/831285","article-title":"Management of mesh complications after SUI and POP repair: review and analysis of the current literature","volume":"2015","author":"Barski","year":"2015","journal-title":"Biomed Res Int"},{"key":"B15","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1097\/AOG.0000000000005021","article-title":"Long-term data on graft-related complications after sacrocolpopexy with lightweight compared with heavier-weight mesh","volume":"141","author":"Page","year":"2023","journal-title":"Obstet Gynecol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"414","DOI":"10.5603\/gpl.101432","article-title":"Current approach to the use of transvaginal mesh systems in pelvic organ prolapse","volume":"96","author":"Pycek","year":"2025","journal-title":"Ginekol Pol"},{"key":"B17","year":"2019"},{"key":"B18","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.tjog.2021.01.031","article-title":"The efficacy and complications of using transvaginal mesh to treat pelvic organ prolapse in Taiwan: a 10-year review","volume":"60","author":"Sun","year":"2021","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1016\/j.jmig.2024.09.788","article-title":"11601 Complications and efficacy after transvaginal mesh repair for Chinese women in the primes registry","volume":"31","author":"Liang","year":"2024","journal-title":"J Minim Invasive Gynecol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"CD012079","DOI":"10.1002\/14651858.CD012079","article-title":"Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse","volume":"2","author":"Maher","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.ejogrb.2024.01.015","article-title":"Diagnosis and management of complications following pelvic organ prolapse surgery using a synthetic mesh: french national guidelines for clinical practice","volume":"294","author":"Deffieux","year":"2024","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"30","DOI":"10.4103\/gmit.GMIT-D-24-00016","article-title":"Size does matter: long-term efficacy and safety of minimesh in transvaginal pelvic organ prolapse repair","volume":"15","author":"Gold","year":"2026","journal-title":"Gynecol Minim Invasive Ther"},{"key":"B23","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.ijsu.2017.02.006","article-title":"Transvaginal PVDF-mesh for cystocele repair: a cohort study","volume":"39","author":"Barski","year":"2017","journal-title":"Int J Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3393\/jksc.2011.27.1.5","article-title":"Surgical treatment of rectal prolapse","volume":"27","author":"Shin","year":"2011","journal-title":"J Korean Soc Coloproctol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2069","DOI":"10.1111\/codi.17191","article-title":"Anal sphincter function in rectal intussusception and high and low \u201ctake-off\u201d external rectal prolapse-A prospective observational study","volume":"26","author":"O'Connor","year":"2024","journal-title":"Colorectal Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1177\/003591575905200805","article-title":"A new operation for rectal prolapse","volume":"52","author":"Wells","year":"1959","journal-title":"Proc R Soc Med"},{"key":"B27","first-page":"1225","article-title":"The surgical treatment of rectal procidentia","volume":"129","author":"Frykman","year":"1969","journal-title":"Surg Gynecol Obstet"},{"key":"B28","first-page":"1925","article-title":"An epidemiologic study of pelvic organ prolapsein rural Chinese women: a population-based sample in China","volume":"30","author":"Li","year":"2019","journal-title":"IntUrogynecol J"},{"key":"B29","doi-asserted-by":"publisher","first-page":"365","DOI":"10.4103\/2141-9248.165256","article-title":"Concurrent occurrence of uterovaginal and RP: an uncommon presentation","volume":"5","author":"Umeh","year":"","journal-title":"Ann Med Health Sci Res.2015"},{"key":"B30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.5152\/jtgga.2011.67","article-title":"Approach to concomitant rectal and uterine prolapse: case report","volume":"13","author":"Karatake","year":"2012","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"B31","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3760\/cma.j.cn112141-20250220-00058","article-title":"Safety and long-term efficacy of transvaginal reconstructive pelvic surgery for severe pelvic organ prolapse in elderly women aged 70 years and over","volume":"60","author":"Zhang","year":"2025","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e2231869","DOI":"10.1001\/jamanetworkopen.2022.31869","article-title":"Effectiveness of self-cut vs mesh-kit Titanium-coated polypropylene mesh for transvaginal treatment of severe pelvic organ prolapse: a multicenter randomized noninferiority clinical trial","volume":"5","author":"Chen","year":"2022","journal-title":"JAMA Netw Open"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1873845\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:54:04Z","timestamp":1784634844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1873845\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":32,"alternative-id":["10.3389\/fsurg.2026.1873845"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1873845","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1873845"}}