Surgical management of the rectocele – An update

Aubert, M; Mège, Diane; Nho, R. Le Huu; Meurette, G.; Sielezneff, I.

doi:10.1016/j.jviscsurg.2020.10.001

Cited by 8 publications

(8 citation statements)

References 64 publications

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“…Significant improvements in urinary incontinence were observed after site-specific repairs of levels I and II in patients who underwent posterior vaginal wall compartment surgery with or without repair of other vaginal compartments with prolapse. However, the inferior defects did not improve significantly after the repair [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of manometric results following posterior pericervical repair or level I to III surgical procedures

Ghanbari,

Pesikhani,

Hosseini

et al. 2023

JMedLife

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Constipation and obstructive bowel disorders are the most common symptoms of prolapse and posterior defects. Prolapse and obstructive defecation disorders are treated using various surgical techniques to repair posterior defects. This study aimed to evaluate the manometry results of patients before and after reconstructive surgery of the posterior compartment. This retrospective cohort study included 40 women with defecation disorders referred to the Imam Khomeini Hospital Complex, an academic center affiliated with Tehran University of Medical Sciences, Tehran, Iran, from 2020 to 2021. Data were collected through medical records and a checklist developed by the researcher before and after surgery. All analyses were performed using SPSS software (version 26), with significance at p<0.05. Forty women with a mean age of 49.47±9.66 years participated in this study. The manometry results showed significant differences in patients before and after surgery in parameters such as maximum resting pressure, push test, constipation, straining during defecation, finger support necessity, sensation of incomplete defecation, dyspareunia, and husband’s sexual satisfaction (p<0.001). In addition, all patients had a grade 2 or higher posterior compartment prolapse, which improved in all cases after surgery (p<0.0001). Patients’ symptoms significantly improved during the 12-month follow-up after DeLancey level 3 to 1 surgery. This type of surgery proved to be an effective surgical intervention without significant complications in the short-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Assessment of manometric results following posterior pericervical repair or level I to III surgical procedures

Ghanbari,

Pesikhani,

Hosseini

et al. 2023

JMedLife

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“…This technique shows improvement in ODS (> 70%) with low morbidity and low recurrence rates (7.5 and 14.2% in 3 and 10 years, respectively) [3]. Although there is an anatomical improvement after surgery, there are studies that report that, however, this improvement is not reflected in defecation symptoms and may even worsen [15].…”

Section: Abdominal Approachmentioning

confidence: 96%

“…Another technique that can be performed in case of incontinence associated or alterations of the anal sphincter suspected is the endoanal of perineal ultrasound [3,4].…”

Section: Perineal Ultrasound It Is Usually Performed In Lithotomy Pos...mentioning

confidence: 99%

“…In the specific case of patients with ODS, the origin could be a functional disorder, and we must demonstrate an anatomical cause through imaging that justifies the intervention. The surgical indications for a rectocele are normally a size longer than 3 cm [3], or a significant retention of the barium contrast within it, during defecography associated with important symptoms that affect quality of life, such as the need for frequent digitation to achieve defecation [13]. Prior to the indication for surgery, it is essential to inform the patient and determine the expectations that the patient has of the surgical treatment [14].…”

Section: Surgical Indicationmentioning

confidence: 99%

“…Rectocele is defined as a herniation of the anterior rectal wall through the posterior vagina wall into its lumen, caused by weakness of the rectovaginal septum. It is more common in postmenopausal women, and pelvic organ prolapse can occur in more than 50% of parous women [1][2][3][4]. Usually secondary to multiple vaginal deliveries that may cause pelvic floor injuries, or damages in muscles such as the levator ani or at the rectovaginal septum, even or the pudendal nerve.…”

Section: Introductionmentioning

confidence: 99%

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Perspective Chapter: Surgical Management of Symptomatic Rectocele

Pecharromán¹,

Duque²,

Peña³

et al. 2023

Benign Anorectal Disorders - An Update

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Rectocele is defined as a herniation of the anterior rectal wall through the posterior vaginal wall into the vaginal lumen caused by rectovaginal septum weakness. This entity is more common in postmenopausal female patients. Approximately one-third of adult women affected with pelvic organ prolapse have a significant impact on their quality of life and emotional well-being. Up to more than 90% of woman can be asymptomatic. In symptomatic cases, constipation, defecatory disorders such as obstructed syndrome (ODS) or incontinence, vaginal mass, and pelvic discomfort are the main complaints. Surgical treatment is indicated after failure of conservative management. Talking about ODS, nearly 20% of the patients need surgery. Surgical options can be classified as abdominal (being laparoscopic colposacropexy the technique of choice) or perineal approach. In the latter group, the alternatives are transanal (TA), transperineal (TP), and transvaginal (TV) approaches with or without prosthetic material or grafts. Native-tissue transvaginal approach should be preferentially performed as it has shown better results. Nowadays, there is no consensus on what the gold-standard technique is given the lack of strong evidence.

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