Affiliation:
1. Department of Colorectal Surgery, St George's Hospital, London, UK
Abstract
Abstract
Background
Rectoceles are traditionally repaired transvaginally and sexual dysfunction can be a significant complication. The aim of this study was to evaluate the functional and physiological outcome following transanal repair of rectoceles.
Methods
Forty-five patients of mean age 57·1 (range 34–78) years with a symptomatic anterior rectocele, selected by contrast retention greater than 15 per cent on isotope defaecography, underwent transanal repair of rectocele. Preoperative and postoperative symptoms were assessed by means of a questionnaire. A proportion of patients underwent anorectal physiology and isotope defaecography before and after surgery.
Results
Median(range) follow-up was 24 (2–50) months. One patient developed a wound infection after surgery. Thirty-five patients reported an excellent, good or fair result, with seven reporting a moderate and three a poor result. There was a reduction in incomplete evacuation (P < 0·001) confirmed by isotope defaecography (mean(s.d.) rectal emptying before surgery 57(14) per cent versus 76(9) per cent after surgery; P = 0·020), and a reduction in vaginal (P < 0·001) and perineal (P = 0·004) digitation. Symptomatic feeling of prolapse (vaginal bulging) was significantly improved (P < 0·001). There was no increase in incontinence (P = 0·688). Resting and squeeze anal canal pressures were unchanged after operation. Surgery did not result in sexual dysfunction.
Conclusion
Transanal repair of rectocele is a safe alternative to posterior colporrhaphy. It provides improvement in symptoms, reflected by anatomical improvement with minimal complications and no increase in dyspareunia.
Publisher
Oxford University Press (OUP)
Cited by
42 articles.
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