Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele.
10.3393/jksc.2012.28.3.140
- Author:
Choon Sik CHUNG
1
;
Sang Hwa YU
;
Jeong Eun LEE
;
Dong Keun LEE
Author Information
1. Department of Surgery, Hansol Hospital, Seoul, Korea. drcschung@hanmail.net
- Publication Type:Original Article
- Keywords:
Rectocele;
Levator;
Transanal;
Transvaginal
- MeSH:
Defecography;
Female;
Follow-Up Studies;
Humans;
Manometry;
Rectocele
- From:Journal of the Korean Society of Coloproctology
2012;28(3):140-144
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure. METHODS: Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months. RESULTS: On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 +/- 0.20 vs. 2.25 +/- 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (> or =4 cm) after the procedure (P = 0.001) CONCLUSION: In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased.