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Obstructed Defecation Syndrome and Rectocele Repair Using Transperineal Bioabsorbable Mesh

  • Surgical Techniques and Innovations
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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.

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References

  1. Richardson AC (1993) The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol 36(4):976–983

    Article  CAS  PubMed  Google Scholar 

  2. Palit S, Bhan C, Lunniss P et al (2014) Evacuation proctography: a reappraisal of normal variability. Colorectal Dis 16:538–546

    Article  CAS  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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&sectionid=231377134

  5. 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/

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

  8. Karram M, Maher C (2013) Surgery for posterior vaginal wall prolapse. Int Urogynecol J 24(11):1835–1841

    Article  PubMed  Google Scholar 

  9. Maher C, Feiner B, Baessler K et al (2014) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4:CD004014

    Google Scholar 

  10. Roman H, Michot F (2005) Long-term outcomes of transanal rectocele repair. Dis Colon Rectum 48:510–517

    Article  PubMed  Google Scholar 

  11. 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

    Article  CAS  PubMed  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    Google Scholar 

  18. 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

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Muhammed Kadir Yıldırak.

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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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