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Initial experience with rectocele repair using nonfrozen cadaveric fascia lata interposition
Kathleen C Kobashi1, Gary E Leach, Robert Frederick
1Continence Center, Virginia Mason Medical Center, Seattle, Washington 98111, USA. urokck@vmmc.org
Urology
|December 20, 2005
Summary
This study introduces a rectocele repair using human fascia lata, showing high success rates and reduced dyspareunia. The technique offers a durable solution for rectocele symptoms.
Area of Science:
- Pelvic reconstructive surgery
- Female pelvic medicine and reconstructive surgery
Background:
- Rectocele repair traditionally relies on native tissue support, which can be insufficient.
- Existing methods may lead to complications like dyspareunia and recurrence.
Purpose of the Study:
- To describe a novel rectocele repair technique using solvent-dehydrated, gamma-irradiated, human fascia lata.
- To evaluate the early outcomes, focusing on durability and reduction of dyspareunia.
Main Methods:
- Seventy-three patients with symptomatic rectoceles underwent repair reinforced with cadaveric fascia lata.
- Data collected via questionnaires, chart review, and blinded third-party interviews.
- Physical examinations were conducted to assess outcomes.
Main Results:
- 93.6% of patients denied postoperative stool trapping.
- Only 10.3% of sexually active patients reported de novo dyspareunia.
- Minor complications occurred in 24% of patients, with one developing an enterocele.
Conclusions:
- Fascial interposition with human fascia lata provides robust support, avoiding reliance on weakened native tissues.
- This technique prevents vaginal narrowing, potentially decreasing dyspareunia.
- Patient satisfaction and symptom improvement are comparable to traditional repairs, with potential for more durable results.