title: Transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele.
abstract: BACKGROUND
  We evaluated functional and morphological outcomes of transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele.
  
  
  METHODS
  Ten women (median 68 years) underwent transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele. Symptoms and continence were monitored before and after surgery. Manovolumetric study and defecography were performed in 9 of 10 patients before and 3-6 months after surgery. Twenty-one females without anorectal diseases were used as controls in manovolumetric study. The patients were followed up after a median of 89 months (range, 3-103).
  
  
  RESULTS
  Main symptoms (defecatory disorders in 9 patients, vaginal mass in 6, perineal discomfort in 2) disappeared after surgery. Six patients performed digitation preoperatively and gave up digitation on defecation after surgery. Stool incontinence disappeared in 4 of 5 preoperatively incontinent patients (Cleveland clinic score, 5-12) and continence score improved from 5 to 2 in the remaining patient. Three patients with urinary cough incontinence preoperatively did not experience incontinence after surgery but cough incontinence occurred occasionally in an 81-year-old patient postoperatively. Rectocele demonstrated on defecography disappeared postoperatively in all 9 patients who underwent defecography. High threshold volume and maximum tolerable volume, which were observed preoperatively, decreased to control levels after surgery.
  
  
  CONCLUSIONS
  Transvaginal anterior levatorplasty with posterior colporrhaphy might be an option for symptomatic rectocele to improve anorectal and urinary dysfunctions with morphological disorders.
authors: Department of Surgery, Fujita Health University, 1-98, Kutsukake, Toyoake, Aichi 470-1192, Japan. kmaeda@fujita-hu.ac.jp
authors: K
authors: K
authors: Maeda
authors: M
authors: M
authors: Maruta
authors: T
authors: T
authors: Hanai
authors: H
authors: H
authors: Sato
authors: K
authors: K
authors: Masumori
authors: Y
authors: Y
authors: Koide
authors: M
authors: M
authors: Matsumoto
authors: O
authors: O
authors: Ishihara
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D020047:Rectocele / Q000503:physiopathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery