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Related Experiment Videos

Rectocele repair. Four years' experience.

M W Arnold1, W R Stewart, P S Aguilar

  • 1Central Ohio Colon and Rectal Center, Columbus 43215.

Diseases of the Colon and Rectum
|August 1, 1990
PubMed
Summary

Rectocele repair surgery offers improvement for many, but persistent symptoms like constipation and pain remain common. A thorough anorectal examination is crucial before considering surgical intervention.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pelvic Floor Disorders

Background:

  • Rectocele repair is a surgical procedure to correct posterior vaginal wall prolapse.
  • Constipation is a common indication for rectocele repair, but its association with rectocele may be overestimated.

Purpose of the Study:

  • To evaluate the outcomes and complications of rectocele repair.
  • To compare the efficacy of transanal versus transvaginal surgical techniques.
  • To assess the necessity of pre-operative anorectal physiologic examination.

Main Methods:

  • Retrospective review of 64 rectocele repairs over four years.
  • Data collected on patient demographics, surgical approach (transanal vs. transvaginal), indications, complications, and follow-up outcomes.
  • Comparison of outcomes between the two surgical techniques.

Main Results:

  • Overall morbidity was 34% with no mortality. Urinary retention was the most common complication (12.5%).
  • No significant difference in complications between transanal and transvaginal repairs.
  • At follow-up, 54% still experienced constipation, 34% had incontinence, and 17% reported persistent rectal pain. 80% reported overall improvement.
  • Transvaginal repair was associated with a higher incidence of pain.

Conclusions:

  • Rectocele repair can lead to symptom improvement, but persistent constipation and pain are frequent.
  • Transanal and transvaginal approaches show no functional difference, but transvaginal repair may lead to more pain.
  • An unselective approach may contribute to suboptimal results; complete anorectal physiologic examination is recommended prior to repair.

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