Literature review of the outcome of and methods used to improve transperineal repair of rectocele.
Modifications
Outcome
Rectocele
Review
Transperineal repair
Journal
World journal of gastrointestinal surgery
ISSN: 1948-9366
Titre abrégé: World J Gastrointest Surg
Pays: United States
ID NLM: 101532473
Informations de publication
Date de publication:
27 Sep 2021
27 Sep 2021
Historique:
received:
25
01
2021
revised:
18
06
2021
accepted:
22
07
2021
entrez:
8
10
2021
pubmed:
9
10
2021
medline:
9
10
2021
Statut:
ppublish
Résumé
Rectocele is commonly seen in parous women and sometimes associated with symptoms of obstructed defecation syndrome (ODS). To assess the current literature in regard to the outcome of the classical transperineal repair (TPR) of rectocele and its technical modifications. An organized literature search for studies that assessed the outcome of TPR of rectocele was performed. PubMed/Medline and Google Scholar were queried in the period of January 1991 through December 2020. The main outcome measures were improvement in ODS symptoms, improvement in sexual functions and continence, changes in manometric parameters, and quality of life. After screening of 306 studies, 24 articles were found eligible for inclusion to the review. Nine studies (301 patients) assessed the classical TPR of rectocele. The median rate of postoperative improvement in ODS symptoms was 72.7% (range, 45.8%-83.3%) and reduction in rectocele size ranged from 41.4%-95.0%. Modifications of the classical repair entailed omission of levatorplasty, addition of implant, concomitant lateral internal sphincterotomy, changing the direction of plication of rectovaginal septum, and site-specific repair. The transperineal repair of rectocele is associated with satisfactory, yet variable, improvement in ODS symptoms with parallel increase in quality-of-life score. Several modifications of the classical TPR were described. These modifications include omission of levatorplasty, insertion of implants, performing lateral sphincterotomy, changing the direction of classical plication, and site-specific repair. The indications for these modifications are not yet fully clear and need further prospective studies to help tailor the technique to rectocele patients.
Sections du résumé
BACKGROUND
BACKGROUND
Rectocele is commonly seen in parous women and sometimes associated with symptoms of obstructed defecation syndrome (ODS).
AIM
OBJECTIVE
To assess the current literature in regard to the outcome of the classical transperineal repair (TPR) of rectocele and its technical modifications.
METHODS
METHODS
An organized literature search for studies that assessed the outcome of TPR of rectocele was performed. PubMed/Medline and Google Scholar were queried in the period of January 1991 through December 2020. The main outcome measures were improvement in ODS symptoms, improvement in sexual functions and continence, changes in manometric parameters, and quality of life.
RESULTS
RESULTS
After screening of 306 studies, 24 articles were found eligible for inclusion to the review. Nine studies (301 patients) assessed the classical TPR of rectocele. The median rate of postoperative improvement in ODS symptoms was 72.7% (range, 45.8%-83.3%) and reduction in rectocele size ranged from 41.4%-95.0%. Modifications of the classical repair entailed omission of levatorplasty, addition of implant, concomitant lateral internal sphincterotomy, changing the direction of plication of rectovaginal septum, and site-specific repair.
CONCLUSION
CONCLUSIONS
The transperineal repair of rectocele is associated with satisfactory, yet variable, improvement in ODS symptoms with parallel increase in quality-of-life score. Several modifications of the classical TPR were described. These modifications include omission of levatorplasty, insertion of implants, performing lateral sphincterotomy, changing the direction of classical plication, and site-specific repair. The indications for these modifications are not yet fully clear and need further prospective studies to help tailor the technique to rectocele patients.
Identifiants
pubmed: 34621481
doi: 10.4240/wjgs.v13.i9.1063
pmc: PMC8462077
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1063-1078Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: No conflict of interest to be disclosed by the authors.
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