Laparoscopic Reconstructive Repair of Uterine and Rectal Prolapse with Posterior Perineal Hernia after Wide Resection of Soft-tissue Sarcoma of the Buttocks: A Case Report.

Pelvic organ prolapse (POP) with concomitant perineal hernia is an infrequent complication following the resection of soft-tissue sarcoma of the buttocks (BSTS). If present, these cases may be secondary to abdominoperineal resection for rectal carcinoma. Here, we report a rare case of uterine and rectal prolapse with posterior perineal hernia following extensive resection and flap placement for BSTS. We performed laparoscopic subtotal hysterectomy, sacrocolpopexy, and ventral rectopexy for POP reconstruction. In addition, mesh was placed on the pelvic surface of the sacrum to further reinforce the pelvic floor. Long-term benefits and efficiency are achieved through a multidisciplinary surgical approach that addresses both POP and perineal hernia, strengthens the pelvic floor, and may prevent recurrence while also improving patient quality of life.