[Repair of rectovaginal septum with pedicled fascia flap]
Jiangning Wang1, Lianru Zhao, Lin Lin
1Institute of Neuroinformatics, Dalian University of Technology, Dalian Liaoning 116024, PR China. dlwangjn@vip.sina.com
Objective:
To observe the clinical effect of repairing rectovaginal septum with graft of fascia flap with blood vessels.
Methods:
From August 2004 to August 2006, 12 female patients with rectocele were treated, aging 49-73 years. The disease course was from 5 to 30 years(mean, 5.6 years). All patients suffered dysporia. X-ray films showed severe rectocele (> or = 30 mm), or with the descendent perineum syndrome (> or = 40 mm), and inner pendant rectal mucosa (3 cases) and/or narrow anal canal (9 cases). The size of fascia flap ranged from 15 cm x 3 cm to 18 cm x 5 cm.
Results:
The bleeding amount was 800 ml in 2 cases, and 500 ml in 10 cases. All fascia flaps survived. In the 12 patients, 11 had a primary wound healing (Stage I), 1 had a delayed wound healing (Stage II). The donor sites healed at Stage II. Twelve patients could defecate normally 4-6 days after surgery. The legs edema occurred in 2 cases, urinary retention combined with infection occurred in 1 case. And all recovered completely after treatment. Eleven patients were followed up for 6 to 12 months. Digital anorectal examination showed prerectal pouch disappearance, glaze surface and good elasticity. X-ray films and CT showed that the rectocele disappeared.
Conclusion:
The operation of repairing rectovaginal septum with graft of fascia with blood vessels can effectively recover anatomy of rectovaginal septum and its normal biological function.