title: Manometric comparison of anorectal function after posterior vaginal compartment repair with and without mesh.
abstract: BACKGROUND
  Although repair augmented with mesh has been proved its priority in anatomical and functional recovery after anterior compartment reconstruction, the data about posterior compartment are scarce. The aim of this study was to compare bowel functional outcome of posterior vaginal compartment repair with and without mesh in patients with pelvic organ prolapse (POP).
  
  
  METHODS
  This was a prospective, double-blind, clinical pilot study of 22 postmenopausal women with symptomatic POP (overall POP-quantification [POP-Q] Stage III-IV) who underwent total pelvic floor reconstruction. Patients were grouped according to the use of mesh for posterior vaginal compartment repair: A mesh group and a nonmesh group. POP-Q stage, the pelvic floor impact questionnaire short form-7 (PFIQ-7) and anorectal manometry were evaluated before and 3 months after surgery. Anatomical success was defined as POP-Q Stage II or less. A t-test was used to compare preoperative with postoperative data in the two groups.
  
  
  RESULTS
  Totally, 17 (71%) were available for the follow-up. POP-Q measurements improved significantly compared to baseline (P < 0.05) in both groups. No recurrence was observed. Subjects in both groups reported improvement in pelvic floor symptoms, and there was no significant difference in the PFIQ-7 score between groups at follow-up (P > 0.05). Compared with baseline, the nonmesh group exhibited a statistically significant decrease in anal residual pressure, a significant increase in the anorectal pressure difference during bowel movement, and a reduced rate of dyssynergia defecation pattern (P < 0.05).
  
  
  CONCLUSIONS
  Provided there is sufficient support for the anterior wall and apex of vagina with mesh, posterior compartment repair without mesh may be as effective as repair with mesh for anatomical recovery while providing better anorectal motor function.
authors: Shuo
authors: S
authors: Liang
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Lan
authors: L
authors: Zhu
authors: Lei
authors: L
authors: Zhang
authors: Zhi-Jing
authors: ZJ
authors: Sun
authors: Xu
authors: X
authors: Tao
authors: Jing-He Lang
authors: JH
authors: Lang
mesh_terms: D000368:Aged; D003248:Constipation / Q000175:diagnosis / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D013526:Surgical Mesh / Q000009:adverse effects*