Transvaginal posterior colporrhaphy combined with laparoscopic ventral mesh rectopexy for isolated Grade III rectocele: a prospective study of 27 patients
- 9 October 2012
- journal article
- Published by Wiley in Colorectal Disease
- Vol. 14 (11), 1398-1402
- https://doi.org/10.1111/j.1463-1318.2012.03023.x
Abstract
The aim of this study was to evaluate prospectively transvaginal posterior colporrhaphy (TPC) combined with laparoscopic ventral mesh rectopexy (LVR) in patients with a symptomatic isolated rectocele. Patients with these complaints underwent dynamic and static MRI. All consecutive patients with a Grade III (4 cm or more) rectocele and without internal/external rectal prolapse, enterocele and external sphincter damage were operated on. The patients completed the Obstructed Defecation Syndrome (ODS) score and the Cleveland Clinic Incontinence Score (CCIS). All tests were repeated after treatment. Dynamic disorders of the pelvic floor detected by MRI were recorded. In 27 patients [median age 67 (46-73) years], TPC combined with LVR was feasible. Complications were limited to port site infection in two patients. Sexual discomfort (n = 8) due to prolapse diminished in six (75%) patients and in one (4%) de novo dyspareunia developed after treatment. The median follow-up was 12 (10-18) months. The median CCIS was 12 (10-16) before treatment and 8 (7-10) after (P < 0.0001). The median ODS score was 19 (17-23) before and 6 (3-10) after treatment (P < 0.0001). There was no change in urinary symptoms. TPC combined with LVR for obstructed defaecation and faecal incontinence in patients with Grade III rectocele significantly relieves the symptoms of these disorders.This publication has 28 references indexed in Scilit:
- Minimally invasive ventral mesh rectopexy for complex rectocoele: impact on anorectal and sexual functionColorectal Disease, 2011
- Safety and efficacy of laparoscopic ventral mesh rectopexy for complex rectoceleColorectal Disease, 2010
- Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipationColorectal Disease, 2010
- Laparoscopic ventral rectopexy for internal rectal prolapse: short‐term functional resultsColorectal Disease, 2010
- Laparoscopic ventral rectopexy for obstructed defecation syndromeSurgical Endoscopy, 2008
- Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre studyInternational Urogynecology Journal, 2006
- Clinical and Physiologic Outcomes After Transvaginal Rectocele RepairDiseases of the Colon & Rectum, 2006
- Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapseBritish Journal of Surgery, 2004
- Epidemiology of Constipation in North America: A Systematic ReviewThe American Journal of Gastroenterology, 2004
- Preliminary results of a multicentre trial of the electrically stimulated gracilis neoanal sphincterBritish Journal of Surgery, 1999