Evaluation of the fascial technique for surgical repair of isolated posterior vaginal wall prolapse.
OBJECTIVE
To study the anatomic and functional efficacy and assess long-term success of the fascial technique in the repair of rectocele.


METHODS
Forty-two women with symptomatic posterior vaginal wall prolapse of at least stage II underwent a surgical repair using the technique of reconstruction of the rectovaginal septum. These women were evaluated at 6 weeks and 18 months postoperatively for anatomic improvement in the grade of their rectocele and a functional improvement in their vaginal, bowel, and sexual symptoms.


RESULTS
Ninety-five percent (40 of 42) were assessed at 6 weeks and 78.5% (33 of 42) attended follow-up at 18 months. Preoperative symptoms included 1) vaginal protrusion (78%); 2) defecation symptoms (76%), which included fecal incontinence alone in 9.5%, evacuation difficulties in 57%, and both fecal incontinence and evacuation difficulties in 9.5%; and 3) sexual dysfunction (33%). At 6-week follow-up there was resolution of vaginal protrusion in 87.5%, and bowel symptoms in 87%. At 18 months there was anatomic cure in 92%, improvement in defecation in 81%, and improvement of sexual dysfunction in 35%. No major complications were seen.


CONCLUSIONS
This technique is effective in providing relatively long anatomic cure of the rectocele and resolution of its symptoms.
Singh
K
K
Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, London, United Kingdom. kavita@rfhsm.ac.uk
Cortes
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E
Reid
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WM
D000328:Adult; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*; D014621:Vagina / Q000503:physiopathology / Q000601:surgery