Clinical, physiological and radiological assessment of rectovaginal septum reinforcement with mesh for complex rectocele

The British Journal of Surgery
A D'HooreF Penninckx

Abstract

Rectocele can be part of a more complex rectal prolapse syndrome including rectal intussusception and enterocele. This reflects insufficiency at different levels of support in the posterior pelvic compartment. A new technique involving reinforcement of the rectovaginal septum with mesh by a combined laparoscopic and perineal approach was evaluated. The study included 18 patients with a complex rectocele and grade 2-3 rectal intussusception and enterocele (eight patients). Patients had clinical, physiological and radiological follow-up. There was no major perioperative morbidity and mean hospital stay was 4.5 (range 3-7) days. After a mean of 24.2 (range 13-35) months there was no clinical recurrence of rectocele. Symptoms of obstructed defaecation resolved in 14 of 17 patients. The Patient Assessment of Constipation Symptoms score decreased from a mean(s.d.) of 12.6(5.9) to 3.9(4.2), and a rectocele symptom score from 14.3(3.3) to 2.3(2.8). No new-onset constipation, urge or faecal incontinence nor new-onset dyspareunia was reported. Radiological investigation in eight patients revealed a sufficient anatomical repair at the different levels of support. A slight decrease in rectal compliance was measured, with no significant red...Continue Reading

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Citations

Jun 18, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M WongP A Lehur
Sep 22, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G MeuretteP A Lehur
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Jun 25, 2020·International Urogynecology Journal·María Alejandra Rodríguez-AbarcaSantos Guzman-Lopez

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