Site-specific rectocele repair compared with standard posterior colporrhaphy.
OBJECTIVE
To compare the anatomic and functional outcomes of site-specific rectocele repair and standard posterior colporrhaphy.


METHODS
We reviewed charts of all patients who underwent repair of advanced posterior vaginal prolapse in our institution between July 1998 and June 2002 with at least 1 year of follow-up.


RESULTS
This study comprised 124 consecutive patients following site-specific rectocele repair and 183 consecutive patients following standard posterior colporrhaphy without levator ani plication. Baseline characteristics, including age, body mass index, parity, previous pelvic surgeries, and preoperative prolapse were not significantly different between the 2 study groups. Recurrence of rectocele beyond the midvaginal plane (33% versus 14%, P = .001) and beyond the hymenal ring (11% versus 4%, P = .02), recurrence of a symptomatic bulge (11% versus 4%, P = .02), and postoperative Bp point (-2.2 versus -2.7 cm, P = .001) were significantly higher after the site-specific rectocele repair. Rates of postoperative dyspareunia (16% versus 17%), constipation (37% versus 34%), and fecal incontinence (19% versus 18%) were not significantly different between the 2 study groups.


CONCLUSIONS
Site-specific rectocele repair is associated with higher anatomic recurrence rates and similar rates of dyspareunia and bowel symptoms than standard posterior colporrhaphy.


METHODS
II-3.
Abramov
Yoram
Y
Evanston Continence Center, Evanston Northwestern Healthcare, Northwestern University, Feinberg School of Medicine, 1000 Central Street, Evanston, IL 60201, USA. y-abramov@northwestern.edu
Gandhi
Sanjay
S
Goldberg
Roger P
RP
Botros
Sylvia M
SM
Kwon
Christina
C
Sand
Peter K
PK
D000368:Aged; D015331:Cohort Studies; D003127:Colposcopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications; D011336:Probability; D011788:Quality of Life; D020047:Rectocele / Q000175:diagnosis* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome