Results of rectocele repair

Mellgren, Anders; Anzén, Bo; Nilsson, Bengt; Johansson, Claes; Dolk, Anders; Gillgren, Peter; Bremmer, Staffan; Holmström, Bo

doi:10.1007/bf02053850

Cited by 262 publications

(156 citation statements)

References 31 publications

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“…The remaining 4 (22%; Group III) were referred to surgical repair. Our results match findings from other series (12,26) . The two most common forms of biofeedback therapy are anal manometry (used in the present study) and electromyography of the anal sphincter (13) .…”

Section: Discussionsupporting

confidence: 93%

“…On the other hand, the technique can not be used to quantify contrast retention. Some authors have suggested that rectocele should not be repaired if the contrast is completely eliminated during defecography (26) . Others have failed to demonstrate any correlation between defecography findings and surgical outcome (14,16) .…”

Section: Discussionmentioning

confidence: 99%

“…Rectocele was associated with anismus or absence of relaxation in 28/103 (27%). In the literature, anismus is associated with clinically significant rectocele in 20%-80% of cases (17,26) . Biofeedback therapy with anorectal manometry was administered to 18/103 patients with multiple dysfunctions and anismus or non-relaxation.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, other researchers believe specific symptoms such as the need for vaginal or rectal manipulation to empty the rectal ampulla should be included among the criteria. Although the outcome of rectocele repair tends to be poor in patients with slow transit (26) , some authors advocate surgical repair to improve the results of future colonic surgery (30) . Likewise, reduced anal pressure was considered a contraindication for surgery in this study since fecal incontinence has often been reported following stapled transanal repair (21) .…”

Section: Discussionmentioning

confidence: 99%

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Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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-Context -Management of patients with obstructed defecation syndrome is still controversial. Objective -To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. Methods -The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Results -Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associa ted with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Conclusions -Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts. HEADINGS -Rectocele. Constipation. Pelvic floor. Imaging, three-dimensional.None disclosure.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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“…52 Although surgery seems to correct anatomical defects, many side effects may occur (in approximately 50% of cases), such as constipation, fecal incontinence, incomplete bowel emptying, and sexual dysfunction. 193 Surgical treatment for internal rectal prolapse is controversial and is only considered when conservative treatments fail to alleviate the patient's symptoms. 194 Abdominal operations include techniques involving suspension of the prolapsed rectum with or without foreign materials, and sigmoid resection with or without rectopexy.…”

Section: 188mentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Shin

Jung

Lee

et al. 2016

J Neurogastroenterol Motil

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The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.

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Pelvic floor disorders

Jones

2016

Colorectal Surgery

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Results of rectocele repair

Cited by 262 publications

References 31 publications

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Pelvic floor disorders

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