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Br J Surg. 2008 Oct;95(10):1264-72. doi: 10.1002/bjs.6322.

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

Author information

1
Department of Abdominal Surgery, University Clinics Gasthuisberg, Leuven, Belgium. andre.dhoore@uz.kuleuven.ac.be

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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 reduction in rectal capacity.

CONCLUSION:

Complete rectovaginal septum reinforcement with mesh corrected complex rectoceles, with good functional outcome.

PMID:
18720463
DOI:
10.1002/bjs.6322
[Indexed for MEDLINE]

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