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Posterior colporrhaphy: its effects on bowel and sexual function
1Department of Obstetrics and Gynaecology, St. George's Hospital, London, UK.
British Journal of Obstetrics and Gynaecology
|January 1, 1997
Summary
Posterior colporrhaphy corrects rectocele defects in 76% of women but may worsen bowel and sexual function, especially after multiple surgeries. Careful patient selection and bowel habit assessment are crucial before this procedure.
Area of Science:
- Urogynecology
- Pelvic Floor Surgery
- Gastrointestinal Health
Background:
- Rectocele repair is a common surgical procedure.
- Long-term effects on bowel and sexual function require further investigation.
Purpose of the Study:
- To evaluate the anatomical cure rate of posterior colporrhaphy.
- To assess the impact of posterior colporrhaphy on bowel and sexual function from one to six years post-surgery.
Main Methods:
- Retrospective observational study involving 231 women undergoing posterior colporrhaphy.
- Data collected via chart review, interviews, and physical examinations.
- Mean follow-up period of 42.5 months.
Main Results:
- Anatomical cure of rectocele achieved in 76% of women.
- Increased rates of constipation, incomplete bowel emptying, fecal incontinence, and sexual dysfunction post-surgery.
- Significant postoperative symptoms including splinting, soiling, and pain reported by many patients.
Conclusions:
- Posterior colporrhaphy effectively corrects the anatomical defect but does not guarantee improved bowel or sexual function and may exacerbate existing issues.
- The presence of an anatomical rectocele does not always correlate with impaired bowel function.
- Preoperative assessment of bowel habits and consideration of investigations are recommended for selective patient management.