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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
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Defect-specific rectocele repair: medium-term anatomical, functional and subjective outcomes
Rodrigo Guzmán Rojas1,2, Ixora Kamisan Atan3,4, Ka Lai Shek3,5
1Departamento de Ginecología y Obstetricia, Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
Summary
Defect-specific rectocele repair effectively treats posterior vaginal wall prolapse and obstructed defecation. Most patients report improvement, with significant symptom reduction and anatomical restoration after surgery.
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Surgical Innovation
Background:
- Rectocele involves herniation of the rectal wall through the rectovaginal septum, causing posterior vaginal wall protrusion.
- Common symptoms include prolapse sensations and obstructed defecation.
Purpose of the Study:
- To evaluate the subjective, anatomical, and functional outcomes of defect-specific rectocele repair.
- To assess the efficacy of this surgical approach in resolving patient symptoms and restoring pelvic floor anatomy.
Main Methods:
- An internal audit of 137 women undergoing defect-specific rectocele repair.
- Pre- and post-operative assessments included standardized interviews, clinical examinations, and 3D/4D transperineal ultrasound.
- Outcome measures focused on obstructed defecation symptoms, recurrent prolapse, and clinical/ultrasound recurrence rates.
Main Results:
- At a mean follow-up of 1.4 years, 85% of women reported being cured or improved.
- Significant reductions in obstructed defecation (34%) and recurrent prolapse symptoms (25%) were observed.
- Clinical recurrence occurred in 14% and ultrasound recurrence in 20% of patients, with enterocele and hiatal area on Valsalva identified as predictors of recurrence.
Conclusions:
- Defect-specific rectocele repair demonstrates effectiveness in restoring normal anatomy.
- The procedure successfully resolves prolapse and obstructed defecation symptoms.
- This surgical technique offers a viable solution for rectocele management with positive long-term outcomes.
