Durability of success after rectocele repair

The purpose of the study was to determine the durability of success after rectocele repair and to evaluate parameters that might influence long-term results. Twenty-five patients with rectocele were prospectively evaluated both clinically and physiologically. Follow-up was performed twice, at 1 and 5.1 years postoperatively. Twenty-four patients had a long-term follow-up; 21/23 patients (91%) with preoperative symptoms of rectal emptying difficulty reported improvement of their symptoms and 9 of 12 (75%) with preoperative symptoms of pelvic heaviness reported relief at long-term follow-up. All 5 patients with preoperative pathologic transit study had various degrees of rectal emptying difficulty at long-term follow-up. Three of 5 patients with preoperative paradoxical sphincter reaction (PSR) at electromyography (EMG) reported improvement of the symptoms of rectal emptying difficulty at long-term follow-up. Surgery for rectocele is associated with improved symptoms in a majority of patients which are sustained long term. Patients with pathologic transit study may have a less favorable symptomatic outcome. The clinical significance of PSR needs further study.