Aim: to assess of late results of original method of rectocele repair with non-absorbable polypropylene W-form mesh. Patients and methods: the pilot study included 37 patients which underwent surgery for rectocele repair using original technique of W-mesh. The late results were assessed in 21 (56.6 %) of them ≥ 6 month after surgery. Before the surgery and 6 months after, patients underwent a clinical assessment of symptoms. Specialized questionnaires for assessment of constipation (Colonic evacuation disorder scale, PFDI-20, Cleveland Clinic Constipation Score) were used. Defecography and anorectal manometry were performed before and in 6-months after surgery for evaluation of pelvic floor disorders. Results: no obstructive defecation symptoms were revealed in 85.7% of patients 6 month after surgery.In ≥ 6 months after surgery all questionnaires showed decrease in scores by more than 2 times. Comparison of the results before and 6 months after the surgery showed significant differences for all questionnaires (p < 0.0001). According to defecography performed before and after the surgery a significant reduction (p < 0.05) of rectocele depth, time of rectal voiding (decreased by 1.5 times) and residual volume of contrast agent (decreased by 2.5 times) were revealed. There are no severe complications requiring re-operation were observed. Conclusion: transvaginal mesh repair of symptomatic rectocele demonstrated good clinical results 6 months after surgery. Good results were revealed in 85,7 % of patients confirmed by specialized questionnaires and defecography.
Aim. A methodological review on mesh implantation efficacy assessment in surgery for rectocele.Key points. Specialised quiz surveys are among the most appropriate methods to assess surgical intervention efficacy. The questionnaires that enable pre- and postsurgery rectocele grading include PFDI-20 (Pelvic Floor Distress Inventory), the colonic evacuation disorder scale and Cleveland Constipation Scoring System. These surveys determine the surgical intervention efficacy dynamically in conjunction with instrumental surgery assessment techniques.Conclusion. Clinical practice at the Ryzhikh National Medical Research Centre for Coloproctology combines the originally developed colonic evacuation disorder scale (2003) and PFDI-20. The combined scales allow for a comprehensive symptom assessment in patients with rectocele and other descending perineum syndrome manifestations prior to surgery, as well as symptom dynamics evaluation postoperatively, which, in link with defecography, enables a complete appraisal of the surgical effect.
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