title: Selection criteria for surgery in patients with obstructed defecation, rectocele and anorectal prolapse.
abstract: The aim of this study was to evaluate the impact of applying strict selection criteria to patients with symptoms of obstructed defecation, rectocele and rectal prolapse who were candidates for surgery. From June 2001 to September 2003, 20 patients underwent surgery in our clinic for symptomatic rectocele and anorectal prolapse. They were evaluated prospectively using a dedicated questionnaire (KESS), a proctological and gynaecological examination, colpo-cysto-defecography and anorectal manometry before surgery and 6 months postoperatively. Strict selection criteria were used for surgery. After 6 months the questionnaire showed an important improvement in symptoms. The symptoms of obstructed defecation and vaginal bulging improved significantly. The average KESS score dropped from 17.65 preoperatively to 5.8 six months after surgery. In the treatment of pelvic floor disease, it is important to evaluate both the uro-gynaecological and the proctological symptoms with the utmost care, obtaining an accurate clinical picture with the aid of dedicated questionnaires and a thorough clinical examination. Evaluation of the effectiveness of surgery for constipation necessarily includes assessing the strength of the indications for surgery, irrespective of the surgical technique adopted, but there is currently no standardised test method for recording and comparing the symptoms of constipation.
authors.affiliation: 3rd General Surgery Clinic, Department of Medical and Surgical Sciences, Coloproctological Unit, S. Antonio Hospital, University of Padua.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Finco
authors.forename: Barbara
authors.initials: B
authors.lastname: Luongo
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
authors.forename: Francesca
authors.initials: F
authors.lastname: Polato
authors.forename: Giacomo
authors.initials: G
authors.lastname: Sarzo
authors.forename: Valentina
authors.initials: V
authors.lastname: Caruso
authors.forename: Franca
authors.initials: F
authors.lastname: De Lazzari
authors.forename: Stefano
authors.initials: S
authors.lastname: Merigliano
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation / Q000175:diagnosis / Q000601:surgery*; D019841:Defecography; D005260:Female; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D018579:Patient Selection; D017773:Pelvic Floor / Q000002:abnormalities; D011351:Proctoscopy; D011446:Prospective Studies; D020127:Recovery of Function; D012005:Rectal Prolapse / Q000175:diagnosis / Q000601:surgery*; D020047:Rectocele / Q000175:diagnosis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome