Anal Continence After Rectocele Repair

Abstract

There are few data concerning patients with rectocele who have associated anal incontinence, however, surgical decision analysis resulted in improvement in both constipation and incontinence in the majority of our patients with rectocele. Nevertheless, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Outcomes After Transanal Repair of Rectoceles

“…Anatomic and functional improvements with this technique have been described by many authors in both prospective and retrospective studies. [7][8][9][10][11][12][13][14][15][16][17][18] In the present study, we sought to demonstrate improvement in bowel function after transanal rectocele repair using a validated scoring system and to compare these postoperative results to those reported by a control group of asymptomatic patients. …”

Postoperative Komplikationen nach Stapler-Hämorrhoidopexie (PPH) und STARR-Operationen

“…Neben Anismus, Enterozele und möglicherweise mentalen Erkrankungen ist eine weitere Kontraindikation der STARR-Methode ein schwacher Sphinkter, da bis zu 23% der Patienten mit dieser Operation Inkontinenz oder Stuhldrang [139] entwickeln. Die Häufigkeit eines neuen Auftretens von Inkontinenz nach konventioneller Rektozelenreparatur hingegen liegt zwischen 0% und 8% [157,158] und vaginale Eingriffe haben kein Inkontinenzrisiko.…”

How clinically important is ultrasonographic definition of the rectogenital septum in surgical decision‐making?

“…In this regard, 3D transvaginal ultrasound provides exquisite images of levator damage, yet the gynecologist's aims differ from those of the colorectal surgeon, who is more preoccupied with postoperative evacuatory (and continence) function. There is little available evidence to support the use of levatorplasty, when levator avulsion may in many cases have little bearing on preoperative functional status 15,16 , but levator repair may actually contribute to postoperative evacuatory difficulty. The treatment of patients with appropriate subcategorization will be based on building a harmony between their symptoms and demonstrable defects and pathologies, when more standardized treatment falls better within the sphere of a multidisciplinary specialized surgical community than it does in the hands of the isolated surgeon married to his or her time-honored operations.…”