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Anterolateral rectopexy for correction of rectoceles leads to good anatomical but poor functional results
J Vermeulen1, J F Lange, A C Sikkenk
1MCRZ locatie Zuider, Department of Surgery, Medisch Centrum Rijnmond Zuid, Olympiaweg 350, Rotterdam, The Netherlands. VermeulenJ@MCRZ.nl
Background:
Several different surgical repair procedures for symptomatic rectocele have been described with variable results. In our clinic, a modified anterolateral rectopexy is used. In this article we evaluate our results, with emphasis on patient satisfaction.
Methods:
From 2001 until 2003, twenty patients with a symptomatic rectocele were treated by anterolateral rectopexy. The preoperative dynamic defecogram and anorectal complaints were analyzed and compared to postoperative outcome via a standardized questionnaire.
Results:
After surgery, all rectoceles were restored as shown by postoperative defecogram. Anorectal symptoms (incomplete evacuation, continuous urge, prolapse, digital evacuation) were improved in 40%. As new-onset symptoms, dyspareunia (50%), digital support (55%) and incomplete evacuation (75%) were mentioned frequently. Most of the patients with larger rectoceles (>3.5 cm) had increased anorectal complaints after surgery.
Conclusions:
Anterolateral rectopexy for treatment of rectocele give limited improvement of anorectal complaints. Besides, many patients developed new complaints postoperatively and hence overall satisfaction was low.
