Transvaginal rectal repair: a new treatment option for symptomatic rectocele?
OBJECTIVE
Widely differing surgical methods have been propagated to correct symptomatic rectocele. With transvaginal rectal repair (TVRR), we evaluate a method to reestablish the continuity of the rectal muscle wall, strengthen the weakened tunica muscularis, and restore normal rectal capacity and function.


METHODS
Between 1997 and 2003, 102 female patients were treated by TVRR in cases of symptomatic rectocele. Patients without improvement following a stringent conservative treatment for a minimum of 3-6 months were selected for TVRR procedure. Patients with intussusception and slow-transit constipation were excluded from the study. To achieve optimal stabilization of the rectal wall, a transverse gathering of the rectocele was performed by a transvaginal access.


RESULTS
Average patient age was 60.9 years (47-76 years), operation time was 36.5 minutes (29-67 min.), in-hospital treatment lasted 4.1 days (2-7 days), and follow-up was 18.1 months (3-48 months). We observed complications in 11% of cases. Three months after the operation, 81% of the patients were symptom-free or improved. Following an average observation time of 18.1 months (3-48 months), 70% were still symptom-free or improved.


CONCLUSIONS
TVRR allows easy access for rectocele repair with a low rate of complications.
Schwandner
Thilo
T
Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Giessen, Germany. thilo.schwandner@chiru.med.uni-giessen.de
Roblick
Michael H
MH
Hecker
Andreas
A
Brom
Armand
A
Kierer
Walter
W
Padberg
Winfried
W
Hirschburger
Markus
M
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care; D020047:Rectocele / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D014621:Vagina / Q000601:surgery*