title: Role of defecography in predicting clinical outcome of rectocele repair.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of defecography in predicting clinical outcome of rectocele repair.
  
  
  METHODS
  Between January 1988 and July 1994, 74 consecutive patients (median age, 54 (range, 35-81) years) with a rectocele and symptoms of obstructed defecation were studied prospectively. After preoperative evaluation by a standardized questionnaire, physical examination, and defecography, a combined transvaginal/transanal rectocele repair was performed. At follow-up, all patients had defecography. Long-term results were qualified by an independent observer after a median follow-up of 58 (range, 14-89) months as "excellent," "good," or "poor."
  
  
  RESULTS
  Rectocele repair was considered excellent in 37 patients and good in 13 patients. Defecography six months after surgery did not show persistent or recurrent rectocele in any of the patients. Size of the rectocele, barium-trapping in the rectocele, internal intussusception, rectal evacuation, and perineal descent did not appear to influence clinical outcome. Radiologic evidence of anismus did not correlate with long-term results of rectocele repair.
  
  
  CONCLUSIONS
  Combined transanal/transvaginal repair of rectocele is an efficient therapy in patients with obstructed defecation. Various defecographic parameters (size of rectocele, internal intussusception, rectal evacuation, perineal descent, radiologic signs of anismus) do not appear to influence clinical outcome of surgery. The main value of defecography is the objective demonstration of rectocele and any associated abnormalities such as an enterocele preoperatively and again in objective assessment of the postoperative results.
authors.affiliation: Department of General Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: van Dam
authors.forename: A Z
authors.initials: AZ
authors.lastname: Ginai
authors.forename: M J
authors.initials: MJ
authors.lastname: Gosselink
authors.forename: W M
authors.initials: WM
authors.lastname: Huisman
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
authors.forename: W C
authors.initials: WC
authors.lastname: Hop
authors.forename: W R
authors.initials: WR
authors.lastname: Schouten
mesh_terms: D003672:Defecation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007443:Intussusception / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012002:Rectal Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors