The Effect of Transvaginal Prolapse Surgery on Anorectal Function

Abstract

Objective Pelvic floor dysfunction can manifest as a spectrum including anorectal dysfunction, vaginal prolapse, and urinary incontinence. Sacrospinous fixation is a procedure performed by gynecologists to treat vaginal prolapse. The present study aims to evaluate the impact of transvaginal prolapse surgery on anorectal function. Materials and Methods We conducted a retrospective review of patients undergoing sacrospinous fixation surgery for vaginal prolapse between 2014 to 2020. Those with anorectal dysfunction who had also been evaluated by the colorectal service preoperatively and postoperatively were included for analysis. These patients were assessed with symptom-specific validated questionnaires. The effect of surgery on constipation and fecal incontinence symptoms was analyzed. Results A total of 22 patients were included for analysis. All patients underwent transvaginal sacrospinous fixation, and 95.4% also had posterior colporrhaphy for vaginal prolapse. There were a statistically significant improvements in the Fecal Incontinence Severity Index (FISI), the St. Mark's Incontinence Score (Vaizey), the embarrassment and lifestyle components of the Fecal Incontinence Quality of Life Score, the Constipation Scoring System, the Obstructed Defecation Score, and components of the Patient Assessment of Constipation Quality of Life score. Conclusion Transvaginal prolapse surgery leads to a favorable effect on anorectal function, with improvements in both obstructed defecation and fecal incontinence scores in this small series.

Perspective Chapter: Obstructed Defecation – From Diagnosis to Treatment

“…Amongst those with faecal and urinary incontinence, there was a Perspective Chapter: Obstructed Defecation -From Diagnosis to Treatment DOI: http://dx.doi.org/10.5772/intechopen.1002688 statistically significant improvement in symptoms with this gynaecological surgery, illustrating the importance of these ligaments in anorectal and bladder function. A retrospective study also demonstrated an improvement in anorectal function with transvaginal surgery for vaginal prolapse (sacrospinous fixation), including a statistically significant improvement in the obstructed defaecation and constipation scoring system scores [21]. These studies support the concept of pelvic ligamentous integrity being an important element of normal anorectal function (Figure 1).…”