RSS-Feed abonnieren
DOI: 10.1055/s-2003-39038
Rectocele Repair: The Gynecologic Approach
Publikationsverlauf
Publikationsdatum:
07. Mai 2003 (online)
ABSTRACT
Gynecologists commonly perform rectocele repairs to address a herniation of the rectum into the posterior vaginal wall which results in a vaginal bulge. Women with rectoceles generally complain of perineal and vaginal pressure, obstructive defecation, constipation, and the need to splint or digitally reduce the vagina in order to effectuate a bowel movement. Rectoceles arise from either a tear or stretching of the rectovaginal fascia, and are commonly repaired by gynecologists via a posterior colporrhaphy. Although there are high rates of anatomic cures, there are conflicting reports with regard to functional outcome and many report postoperative dyspareunia. A modified repair, the discrete fascial defect repair, shows promising anatomical and functional results.
KEYWORDS
Rectocele - posterior colporrhaphy - site-specific defect rectocele repair - dyspareunia - defecation disorders
REFERENCES
- 1 Brubaker L. Rectocele. Curr Opin Obstet Gynecol . 1996; 8 376-379
- 2 Kahn M A, Stanton S L. Techniques of rectocele repair and their effects of bowel function. Int Urogynecol J . 1998; 9 37-47
- 3 Delancey J OL, Hurd W W. Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse. Obstet Gynecol . 1998; 91 364-368
- 4 Richardson A C. The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol . 1993; 36 976-983
- 5 Uhlenhuth E, Wolfe W M, Smith E M, Middleton E B. The rectogenital septum. Surg Gynecol Obstet . 1948; 86 148-163
- 6 Milley P S, Nichols D H. A correlative investigation of the human rectovaginal septum. Anat Rec . 1969; 163 443-452
- 7 Delancey J OL. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol . 1992; 166 1717-1724
- 8 Shull B L, Bachofen C G. Enterocele and rectocele. In: Walters MD, Karram MM, eds. Urogynecology and Reconstructive Pelvic Surgery, 2nd ed St. Louis: Mosby 1999: 221-234
- 9 Nichols D H. Posterior colporrhaphy and perineorrhaphy: separate and distinct operations. Am J Obstet Gynecol . 1991; 164 714-721
- 10 Francis W J, Jeffcoate T N. Dyspareunia following vaginal operations. J Obstet Gynaecol Br Emp . 1961; 68 1-10
- 11 Kahn M A, Stanton S L. Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynecol . 1997; 104 82-86
- 12 Paraiso M F, Weber A M, Walters M D, Ballard L A, Piedmonte M R, Skibinshi C. Anatomic and functional outcome after posterior colporrhaphy. J Pelvic Surg . 2001; 7 335-339
- 13 Lopez A, Anzen B, Bremmer S. et al . Durability of success after rectocele repair. Int Urogynecol J . 2001; 12 97-103
- 14 Mellgren A, Anzen B, Nilsson B Y. et al . Results of rectocele repair; a prospective study. Dis Colon Rectum . 1995; 38 7-13
- 15 Cundiff G W, Weidner A C, Visco A G, Addison W A, Bump R C. An anatomic and functional assessment of the discrete defect rectocele repair. Am J Obstet Gynecol . 1998; 179 1451-1457
- 16 Porter W E, Steele A, Walsh P, Kohli N, Karram M M. The anatomic and functional outcomes of defect-specific rectocele repairs. Am J Obstet Gynecol . 1999; 181 1353-1358
- 17 Kenton K, Shott S, Brubaker L. Outcome after rectovaginal reattachment for rectocele repair. Am J Obstet Gynecol . 1999; 181 1360-1363
- 18 Glavind K, Madsen H. A prospective study of the discrete fascial defect rectocele repair. Acta Obstet Gynecol Scand . 2000; 79 145-147
- 19 Fox S D, Stanton S L. Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition. Br J Obstet Gynaecol . 2000; 107 1371-1375
- 20 Taylor G M, Ballard P, Jarvis G J. Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition. Br J Obstet Gynaecol . 2001; 8 775-776
- 21 Paraiso M FR, Falcone T, Walters M D. Laparoscopic surgery for enterocele, vaginal apex prolapse and rectocele. Int Urogynecol J . 1999; 10 223-229
- 22 Lyons T L, Winer W K. Laparoscopic rectocele repair using polyglactin mesh. J Am Assoc Gynecol Laparosc . 1997; 4 381-384
- 23 Marks M M. The rectal side of the rectocele. Dis Colon Rectum . 1967; 10 387-388
- 24 Sehapayak S. Transrectal repair of rectocele: an extended armamentarium of colorectal surgeons. Dis Colon Rectum . 1985; 6 422-433
- 25 Arnold M W, Stewart W RC, Aguilar P S. Rectocele: four years' experience. Dis Colon Rectum . 1990; 33 684-687