Site-Specific Rectocele Repair Compared With Standard Posterior Colporrhaphy

Evanston Continence Center, Evanston Northwestern Healthcare, Northwestern University, Feinberg School of Medicine, 1000 Central Street, Evanston, IL 60201, USA.
Obstetrics and Gynecology (Impact Factor: 4.37). 03/2005; 105(2):314-8. DOI: 10.1097/01.AOG.0000151990.08019.30
Source: PubMed

ABSTRACT To compare the anatomic and functional outcomes of site-specific rectocele repair and standard posterior colporrhaphy.
We reviewed charts of all patients who underwent repair of advanced posterior vaginal prolapse in our institution between July 1998 and June 2002 with at least 1 year of follow-up.
This study comprised 124 consecutive patients following site-specific rectocele repair and 183 consecutive patients following standard posterior colporrhaphy without levator ani plication. Baseline characteristics, including age, body mass index, parity, previous pelvic surgeries, and preoperative prolapse were not significantly different between the 2 study groups. Recurrence of rectocele beyond the midvaginal plane (33% versus 14%, P = .001) and beyond the hymenal ring (11% versus 4%, P = .02), recurrence of a symptomatic bulge (11% versus 4%, P = .02), and postoperative Bp point (-2.2 versus -2.7 cm, P = .001) were significantly higher after the site-specific rectocele repair. Rates of postoperative dyspareunia (16% versus 17%), constipation (37% versus 34%), and fecal incontinence (19% versus 18%) were not significantly different between the 2 study groups.
Site-specific rectocele repair is associated with higher anatomic recurrence rates and similar rates of dyspareunia and bowel symptoms than standard posterior colporrhaphy.

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    • "Myorraphie haute 36 ? 14 Gêne sexuelle chez 3 patientes Weber et al. (2000) [21] Colporraphie postérieure ± autres gestes 53 53 53 26 % de dyspareunie postopératoire (significativement plus élévé qu'en l'absence de colporraphie postérieure) Abramov et al. (2005) [80] Réparation postérieure « site spécifique » "
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    • "Abdominal hysterectomy/ colposacropexy 95% Vs. 95% 12 1b Maher [53] 43 Uterine prolapse Laparoscopic hysteropexy 79% 12 3 Barranger [54] 30 Uterine prolapse Abdominal sacrohysteropexy + Burch + posterior colporrhaphy 93% 44 3 Posterior vaginal wall prolapse Kahn [21] 63 Rectocele Transanal repair Vs. Posterior colporrhaphy 70% Vs. 87.5% 25 2 Nieminem [28] 30 Rectocele Rectovaginal fascia plication 60% Vs. 91% ( p < 0.05) 12 2 Abramov [60] 307 Rectocele Midline fascial plication Vs. Discrete fascial repair 96% Vs. 60% >12 2 3 . "
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