title: [Functional results after transvaginal, transperineal and transrectal correction of a symptomatic rectocele].
abstract: BACKGROUND
  The aim of this study was to compare functional outcome after transvaginal, transperineal and transrectal repair of a symptomatic rectocele and to develop the ideal surgical approach.
  
  
  METHODS
  28 patients (27 female, 1 male) who had undergone rectocele repair from 1996 to 2003 were analysed. Mean age was 59 years (range 30-79 years), follow-up was 24 months (range 3 to 70 months) and mean appearance of symptoms was 4 years prior to the operation (6 months-32 years). Transvaginal repair was performed in 13 cases, transperineal repair in 8 cases and transrectal repair in 7 cases.
  
  
  RESULTS
  24 of 28 patients (85.7 %) are satisfied with the operation-result (transvaginal 12 of 13 patients [92.3 %], transperineal 7 of 8 patients [87.5 %] and transrectal 5 of 7 patients [71.4 %]). 25 patients (89.3 %) are free of complaints or describe an evident improvement of symptoms (transvaginal 12 of 13 patients [92.3 %], transperineal 7 of 8 patients [87.5 %] und transrectal 6 of 7 patients [85.7 %]). There is one postoperative dyspareunia.
  
  
  CONCLUSIONS
  Best treatment of a rectocele starts with patients selection. Considering pelvic floor as functional unity, concomitant urologic-gynaecologic lesions and proximal intraabdominal disturbances the appropriate surgical procedure is selected.
  
  
  CONCLUSIONS
  Surgical approach to correct a symptomatic rectocele depends on the concomitant lesion.
authors.affiliation: Klinik für Chirurgie, Universitätsklinikum Schleswig Holstein, Campus Lübeck. Fischer_F@web.de
authors.forename: F
authors.initials: F
authors.lastname: Fischer
authors.forename: S
authors.initials: S
authors.lastname: Farke
authors.forename: O
authors.initials: O
authors.lastname: Schwandner
authors.forename: H P
authors.initials: HP
authors.lastname: Bruch
authors.forename: T
authors.initials: T
authors.lastname: Schiedeck
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D010502:Perineum / Q000601:surgery; D020047:Rectocele / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D014621:Vagina / Q000601:surgery