[New physiological, diagnostic and therapeutic concepts in the management of rectoceles in women].
Anterior rectocele is not only a herniation of the anterior rectal wall into the vagina, but rather a complex anatomical and functional abnormality which may be isolated or associated with other pelvic floor disorders. It could result in rectal obstruction with dyschezia, manual extraction of feces, and fecal or gas incontinence. The purpose of this review is to describe and to assess the most useful methods for the diagnosis and for the treatment of the rectocele. Data from physical examination may be improved by defecography. Surgery remains the main treatment: several surgical ways (perineal, anal, abdominal, laparoscopic) are described. Analysis of the anatomical and functional results allows to assess these techniques and to determine the best therapeutic option.
Deval
B
B
Service de gynécologie-obstétrique, université Bichat-Beaujon, hôpital Beaujon, 100 Boulevard du Général-Leclerc, 92110 Clichy, France. bruno.deval@bjn.ap-hop-paris.fr
Rafii
A
A
Poilpot
S
S
Wicart
F
F
Aflak
N
N
Levardon
M
M
D003672:Defecation; D019841:Defecography; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006547:Hernia; D006801:Humans; D017773:Pelvic Floor / Q000601:surgery; D010808:Physical Examination; D020047:Rectocele / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome