Outcome after rectovaginal fascia reattachment for rectocele repair

Kimberly Kenton*, Susan Shott, Linda Brubaker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

141 Scopus citations

Abstract

OBJECTIVE: This study was undertaken to determine the effects of rectovaginal fascia reattachment on symptoms and vaginal topography. STUDY DESIGN: Standardized preoperative and postoperative assessments of vaginal topography (the Pelvic Organ Prolapse staging system of the International Continence Society, American Urogynecologic Society, and Society of Gynecologic Surgeons) and 5 symptoms commonly attributed to rectocele were used to evaluate 66 women who underwent rectovaginal fascia reattachment for rectocele repair. All patients had abnormal fluoroscopic results with objective rectocele formation. RESULTS: Seventy percent (n = 46) of the women were objectively assessed at 1 year. Preoperative symptoms included the following: protrusion, 85% (n = 39); difficult defecation, 52% (n = 24); constipation, 46% (n = 21); dyspareunia, 26% (n = 12); and manual evacuation, 24% (n = 11). Posterior vaginal topography was considered abnormal in all patients with a mean Ap point (a point located in the midline of the posterior vaginal wall 3 cm proximal to the hymen) value of -0.5 cm (range, - 2 to 3 cm). Postoperative symptom resolution was as follows: protrusion, 90% (35/39; P < .0005); difficult defecation, 54% (14/24; P < .0005); constipation, 43% (9/21; P= .02); dyspareunia, 92% (11/12; P = .01); and manual evacuation, 36% (4/11; P = .125). Vaginal topography at 1 year was improved, with a mean Ap point value of -2 cm (range, -3 to 2 cm). CONCLUSION: This technique of rectocele repair improves vaginal topography and alleviates 3 symptoms commonly attributed to rectoceles. It is relatively ineffective for relief of manual evacuation, and constipation is variably decreased.

Original languageEnglish (US)
Pages (from-to)1360-1364
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume181
Issue number6
DOIs
StatePublished - 1999

Keywords

  • Fluoroscopy
  • Posterior colporrhaphy
  • Rectocele
  • Rectocele repair
  • Rectovaginal fascia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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