[Functional results after transvaginal, transperineal and transrectal correction of a symptomatic rectocele].
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.
Fischer
F
F
Klinik für Chirurgie, Universitätsklinikum Schleswig Holstein, Campus Lübeck. Fischer_F@web.de
Farke
S
S
Schwandner
O
O
Bruch
H P
HP
Schiedeck
T
T
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