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Rectocele: pathogenesis and surgical management.

A P Zbar1, A Lienemann, H Fritsch

  • 1Department of Medicine and Clinical Research, Queen Elizabeth Hospital, University of the West Indies, Martindales Road, St. Michael, Barbados. apzbar@hotmail.com

International Journal of Colorectal Disease
|April 1, 2003
PubMed
Summary
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Rectocele repair outcomes are debated due to limited data. This review assesses surgical techniques for rectocele, a common cause of difficult bowel movements, to improve patient care.

Area of Science:

  • Female pelvic medicine
  • Coloproctology
  • Pelvic floor disorders

Background:

  • Rectocele is a frequent cause of difficult defecation.
  • Current surgical management and pathogenesis remain controversial.
  • Many studies lack comprehensive functional outcome data.

Purpose of the Study:

  • To review the clinical results of defect-specific rectocele repairs.
  • To assess different surgical approaches: endorectal, transvaginal, transperineal, and combined.
  • To evaluate pre- and postoperative symptoms related to rectocele repair.

Main Methods:

  • A Medline-based literature search was conducted.
  • Included studies reported pre- and postoperative symptoms.
  • Focused on defect-specific rectocele repairs.

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Main Results:

  • Limited prospective data exists on functional outcomes after rectocele repair.
  • Newer imaging modalities reveal multiple pelvic floor disorders.
  • Endorectal defect-specific repair is common, but lacks randomized controlled data.

Conclusions:

  • Investigation and surgical management of rectocele are controversial.
  • A multicenter randomized trial is recommended for comparing surgical approaches.
  • Standardized outcome criteria are needed for evaluating rectocele repair.