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Anal continence after rectocele repair
Stella M Ayabaca1, Andrew P Zbar, Mario Pescatori
1Coloproctology Unit, Villa Claudia Hospital, Rome, Italy.
Diseases of the Colon and Rectum
|January 12, 2002
Summary
Surgical repair of rectocele improved constipation and anal incontinence in most patients. However, full continence was not achieved, suggesting pelvic floor rehabilitation may be beneficial for enhanced sphincter function.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Rectocele can cause chronic constipation and anal incontinence.
- Various surgical techniques exist for rectocele repair.
- This study evaluates outcomes for selected endorectal or transperineal rectocele surgery.
Purpose of the Study:
- To assess anorectal function and clinical outcomes after rectocele surgery.
- To analyze the effectiveness of surgical treatment for rectocele, particularly in patients with incontinence.
- To correlate surgical approach with clinical and functional results.
Main Methods:
- Sixty patients with symptomatic rectocele underwent endorectal or transperineal surgery.
- Preoperative assessments included manometry, endoanal ultrasonography, and defecography.
- Surgical approach was determined by clinical presentation (obstructed defecation vs. incontinence).
Main Results:
- No operative mortality; 30% postoperative complications.
- Of 43 incontinent patients, 79% showed improved continence (none fully continent).
- Constipation improved in all patients; anal pressures showed non-significant changes.
Conclusions:
- Surgical repair of rectocele can improve constipation and incontinence symptoms.
- Pelvic floor rehabilitation may be necessary to achieve optimal sphincter function post-surgery.
- Further research is needed for patients with rectocele and associated anal incontinence.