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[Functional results after transvaginal, transperineal and transrectal correction of a symptomatic rectocele]
F Fischer1, S Farke, O Schwandner
1Klinik für Chirurgie, Universitätsklinikum Schleswig Holstein, Campus Lübeck. Fischer_F@web.de
Introduction:
The aim of this study was to compare functional outcome after transvaginal, transperineal and transrectal repair of a symptomatic rectocele and to develop the ideal surgical approach.
Patients And Method:
28 patients (27 female, 1 male) who had undergone rectocele repair from 1996 to 2003 were analysed. Mean age was 59 years (range 30-79 years), follow-up was 24 months (range 3 to 70 months) and mean appearance of symptoms was 4 years prior to the operation (6 months-32 years). Transvaginal repair was performed in 13 cases, transperineal repair in 8 cases and transrectal repair in 7 cases.
Results:
24 of 28 patients (85.7 %) are satisfied with the operation-result (transvaginal 12 of 13 patients [92.3 %], transperineal 7 of 8 patients [87.5 %] and transrectal 5 of 7 patients [71.4 %]). 25 patients (89.3 %) are free of complaints or describe an evident improvement of symptoms (transvaginal 12 of 13 patients [92.3 %], transperineal 7 of 8 patients [87.5 %] und transrectal 6 of 7 patients [85.7 %]). There is one postoperative dyspareunia.
Discussion:
Best treatment of a rectocele starts with patients selection. Considering pelvic floor as functional unity, concomitant urologic-gynaecologic lesions and proximal intraabdominal disturbances the appropriate surgical procedure is selected.
Conclusion:
Surgical approach to correct a symptomatic rectocele depends on the concomitant lesion.
