Document Detail


Clinical, physiological and radiological assessment of rectovaginal septum reinforcement with mesh for complex rectocele.
MedLine Citation:
PMID:  18720463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A D'Hoore; D Vanbeckevoort; F Penninckx
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  95     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-09-25     Revised Date:  2009-03-10    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1264-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Abdominal Surgery, University Clinics Gasthuisberg, Leuven, Belgium. andre.dhoore@uz.kuleuven.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Dissection
Female
Follow-Up Studies
Humans
Intussusception / physiopathology,  radiography,  surgery*
Laparoscopy
Manometry
Middle Aged
Polypropylenes / therapeutic use
Rectocele / physiopathology,  radiography,  surgery*
Rectum / surgery*
Surgical Mesh*
Suture Techniques
Vagina / surgery*
Chemical
Reg. No./Substance:
0/Polypropylenes
Comments/Corrections
Comment In:
Br J Surg. 2009 Mar;96(3):322; author reply 322   [PMID:  19224525 ]

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