[Disabling rectocele: rectal plication by perineal approach. Apropos of 20 cases]

Rectocele is a frequent rectal static disorder. Its usual clinical manifestation is a distressing outlet obstruction. Surgical treatments actually proposed are based on a trans-anal approach. Perineal approach has specific interests as shown on a consecutive series of 20 patients operated on between January 90 and January 92. The surgical modalities were, after mobilization of the recto-vaginal wall, careful concentric folding of the rectocele followed by suturing the rectal fascia and pre-anal levatorplasty without associated colpectomy. Results (mean follow-up: 15 months) showed: 1) anatomic correction obtained in 18 cases, without local complications, but one dyspareunia, 2) restoration of normal rectal evacuation in 16 cases. The 4 functional failures were observed in patients with associated anorectal disorders (anismus, colon inertia).