Perineal Hernia in Women : Assessment with Evacuation Fluoroscopic Cystocolpoproctography

Abstract

Summary:The aim of this study is to assess the usefulness of fluoroscopic cystocolpoproctography in the treatment of female pelvic organ prolapse. The presence or absence of rectocele, enterocele, sigmoidocele, and the cystocele on cystocolpoproctography was retrospectively analyzed in 46 consecutive patients. A rectocele was detected in 4.5% of the patients, postvaginal hernia in 19.7%, cystocele in 3.0%, complete rectal prolapse in 53.0%, massive rectal prolapse in 10.6%, and incomplete rectal prolapse in 4.5% of the patients on cystocolpoproctography. Perineal hernia can include a combination of cystocele, rectocele, uterine prolapse, enterocele and rectal prolapse. Accurate diagnosis of the coexisting abnormalities is essential in planning reconstructive procedures so that the risks of recurrence and reoperation can be minimized. Fluoroscopic cystocolpoproctography provides direct visualization and quantification of female pelvic organ prolapse, information that usually can only be inferred by physical examination.

Prosthesis ventral colpo-recto-pexy for the restoration of the recto-anal anatomic disorders

“…Transabdominal pro ce dures in the form of ei ther pros the sis or re sec tion rectopexy are as so ci ated re duc tion of pro lapse in per cent ages over 90%. How ever, sat is factory func tional re sults, na-mely im prove ment of ODS and fae cal in con ti nence, are seen in ap prox i mately 60% of pa tients [27][28][29][30][31][32][33] . iv) sigmoidcele and enterocele are termed the con ditions at which the sig moid or ileal loops en ter the deep Douglas pouch dur ing strain ing and ob struct out let by com press ing the an te rior rec tal wall.…”

“…The con di tion usually as so ci ates in ter nal or ORP, and is treated con com itantly to the sur gi cal cor rec tion of rec tal pro lapse. Although rec tal pro lapse may be cor rected by con ven tional pro ce dures, sigmoidocele and enterocele may de velop at strain ing, thus con trib ut ing to per sis tent ODS [33][34][35][36] .…”