Symptomatic rectocele: what are the indications for repair? - 01/03/14
, Skandan Shanmugan, M.D., Tamar Nobel, B.S., Raj Paspulati, M.D., Conor P. Delaney, M.D., Ph.D., Harry L. Reynolds, M.D., Sharon L. Stein, M.D., Bradley J. Champagne, M.D.Abstract |
Background |
The surgical indications for symptomatic rectocele are undefined, and surgery has high recurrence rates. We implemented magnetic resonance imaging defecography (MRID) to determine if utilizing strict inclusion criteria for rectocele repair improves outcomes.
Methods |
Patients with obstructive defecation syndrome (ODS) who underwent dynamic MRID were evaluated. Indications for surgical repair were defecation requiring manual assistance and the following MRID results: anterior defect >2 cm, incomplete evacuation, and the absence of perineal descent. Primary outcomes were the change in quality of life (QOL) scores and recurrence.
Results |
From 2006 to 2013, 143 patients who presented with ODS underwent MRID. Seventeen patients met the criteria for repair. Recurrence was low (5.8%) with a median follow-up of 23 months, QOL scores improved from 57.3 to 76.5 (P = .041).
Conclusions |
A minority of patients (12%) with ODS met the above criteria for rectocele repair. Patients who underwent repair had a significant improvement in QOL and low recurrence rate.
Le texte complet de cet article est disponible en PDF.Keywords : Obstructive defecation syndrome (ODS), Rectocele, Magnetic resonance imaging defecography (MRID), Stapled transanal rectal resection (STARR)
Plan
| The authors declare no conflicts of interest. |
Vol 207 - N° 3
P. 375-379 - mars 2014 Retour au numéro
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