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Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair

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Abstract

Introduction and hypothesis

The present study aimed to assess the changes in manometric parameters after transperineal repair (TPR) of rectocele and interpret failure of symptom improvement in light of these changes.

Methods

This was an observational cohort study on patients with anterior rectocele who underwent TPR in the period of February 2016 to February 2019. Data collected included patients’ demographics, rectocele size, Wexner constipation and incontinence scores, anal pressures, and rectal sensation before and 12 months after TPR. Analysis of data was done by paired t-test and chi-square test.

Results

Forty-six female patients with a mean age of 43.2 ± 10.7 years were included. After a mean follow-up of 13.9 ± 2.7 months, 30 (65.2%) patients reported clinical improvement and 16 (34.8%) had no significant improvement. At 12 months after rectocele repair, the entire cohort studied showed an insignificant increase in the mean anal pressures and a significant decrease in the thresholds of first rectal sensation, first urge, intense urge, and maximum tolerable volume (MTV). Patients who clinically improved showed similar physiologic changes to the entire cohort examined, whereas patients who had no clinical improvement showed significant increases in the mean anal pressures and insignificant decreases in rectal sensation and MTV.

Conclusion

Patients who showed clinical improvement showed insignificant increases in anal pressures and significant decreases in thresholds of first rectal sensation, first urge, intense urge, and MTV. Contrarily, patients who did not show clinical improvement showed significant increases in anal pressures and insignificant reduction in sensory thresholds.

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Funding

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Authors and Affiliations

  1. Colorectal Surgery Unit, General Surgery Department, Mansoura faculty of medicine, Mansoura University, Mansoura city, Egypt

    Sameh Hany Emile, Mohammed Balata, Waleed Omar, Wael Khafagy & Hesham Elgendy

  2. General Surgery Department, Faculty of Medicine, Mansoura University Hospitals, Elgomhuoria Street, Mansoura city, Egypt

    Sameh Hany Emile

Authors
  1. Sameh Hany Emile
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  2. Mohammed Balata
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  3. Waleed Omar
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  4. Wael Khafagy
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  5. Hesham Elgendy
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Contributions

Sameh Emile designed the study. Sameh Emile, Mohammed Balata, and Hesham Elgendy conducted collection and analysis of the data and wrote the manuscript. Wael Khafagy and Waleed Omar conducted interpretation of the results and critically revised the manuscript.

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Correspondence to Sameh Hany Emile.

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All authors declare that they have no conflicts of interest.

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Ethical approval for the study was obtained from the institutional review board of Mansoura Faculty of Medicine.

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Inform consents to participate in the study were not required owing to the nature of the study (retrospective review of data).

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Emile, S.H., Balata, M., Omar, W. et al. Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair. Int Urogynecol J 31, 2019–2025 (2020). https://doi.org/10.1007/s00192-020-04444-9

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  • DOI: https://doi.org/10.1007/s00192-020-04444-9

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