Abstract
Rectocele is a common functional pelvic floor disorder. Its main symptoms are prolonged straining and splinting. Most patients remain asymptomatic. However, symptomatic cases may require surgery. Debates are still ongoing about the optimal surgical approach. Nevertheless, pelvic approaches gained attention especially in old and fragile patients. However, optimal pelvic approach and how it should be performed is still an ongoing debate. In this study we aimed to provide our transperineal rectocele repair experience and 1 year follow-up results.. The outcomes of 50 patients, who underwent transperineal rectocele repair with bioabsorbable mesh augmentation and whose data were recorded prospectively for 1 year, were analyzed in terms of peroperative complications, relief of symptoms, recurrence and new onset dyspareunia. No severe peroperative complications or fecal incontinence were reported. Mild bleeding and surgical site infection were reported in 18% and 14% of patients, respectively. 88% of patients reported total relief of symptoms on first year follow-up, while 8% had no improvement after the surgery and 4% had recurrence. Transperinal rectocele repair with bioabsorbable mesh augmentation is a simple, safe and successful surgical procedure. However, more studies are required to determine its superiority to other pelvic and transabdominal approaches.
References
Richardson AC (1993) The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol 36(4):976–983
Palit S, Bhan C, Lunniss P et al (2014) Evacuation proctography: a reappraisal of normal variability. Colorectal Dis 16:538–546
Gagliardi G, Pescatori M, Altomare DF et al (2008) Results, outcome predictors and complications after stapled transanal rectal resection for obstructed defecation. Dis Colon Rectum 51(2):186–195
Pelvic Organ Prolapse: Uterine Prolapse, Cystocele, Rectocele or Enterocele. In: Papadakis MA, McPhee SJ, Bernstein J. eds. Quick Medical Diagnosis & Treatment 2020. McGraw Hill; 2020. Accessed March 17, 2022. https://accessmedicine.mhmedical.com/content.aspx?bookid=2750§ionid=231377134
Ladd M, Tuma F (2022) Rectocele. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546689/
Felt-Bersma RJ, Tiersma ES, Cuesta MA (2008) Rectal prolapse, rectal intussusception, rectocele, solitary rectal ulcer syndrome, and enterocele. Gastroenterol Clin North Am 37:645–668
Siproudhis L, Lehur PA (2017) Chapter 11: Defecation disorders. In: Lehur PA, Herold A, Matzel KE et al. (eds) Coloproctology, 2nd edn. Springer, pp 130–137. https://doi.org/10.1007/978-3-662-53210-2
Karram M, Maher C (2013) Surgery for posterior vaginal wall prolapse. Int Urogynecol J 24(11):1835–1841
Maher C, Feiner B, Baessler K et al (2014) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4:CD004014
Roman H, Michot F (2005) Long-term outcomes of transanal rectocele repair. Dis Colon Rectum 48:510–517
Wong M, Meurette G, Abet E et al (2011) Safety and efficacy of laparoscopic ventral mesh rectopexy for complex rectocele. Colorectal Dis 13(9):1019–1023. https://doi.org/10.1111/j.1463-1318.2010.02349.x
Leventoğlu S, Menteş BB, Akin M et al (2007) Transperineal rectocele repair with polyglycolic acid mesh: a case series. Dis Colon Rectum 50(12):2085–92. https://doi.org/10.1007/s10350-007-9067-5
Emile SH, Balata M, Omar W et al (2020) Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair. Int Urogynecol J 31(10):2019–2025. https://doi.org/10.1007/s00192-020-04444-9
Balata M, Elgendy H, Emile SH et al (2020) Functional Outcome and Sexual-Related Quality of Life After Transperineal Versus Transvaginal Repair of Anterior Rectocele: A Randomized Clinical Trial. Dis Colon Rectum 63(4):527–537. https://doi.org/10.1097/DCR.0000000000001595
Ellis CN (2010) Outcomes after the repair of rectoceles with transperineal insertion of a bioprosthetic graft. Dis Colon Rectum 53(2):213–218. https://doi.org/10.1007/DCR.0b013e3181c8e549
Dell JR, O’Kelley KR (2005) PelviSoft BioMesh augmentation of rectocele repair: the initial clinical experience in 35 patients. Int Urogynecol J Pelvic Floor Dysfunct 16(1):44–7. https://doi.org/10.1007/s00192-004-1217-x
Leventoğlu S (2007) Transperineal Site-Spesific Fascial Repair vs. Transperineal Polypropylene Mesh Repair of Rectocele: A Randomized Trial. Turk J Colorectal Dis 17:9–15
Fathy M, Elfallal AH, Emile SH (2021) Literature review of the outcome of and methods used to improve transperineal repair of rectocele. World J Gastrointest Surg 13(9):1063–1078. https://doi.org/10.4240/wjgs.v13.i9.1063
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Pala, M.I., Yıldırak, M.K. & Sucullu, I. Obstructed Defecation Syndrome and Rectocele Repair Using Transperineal Bioabsorbable Mesh. Indian J Surg 86, 179–183 (2024). https://doi.org/10.1007/s12262-023-03786-0
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DOI: https://doi.org/10.1007/s12262-023-03786-0