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Functional and Anatomic Outcome After Transvaginal Rectocele Repair Using Collagen Mesh: A Prospective Study

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  • Published:
Diseases of the Colon & Rectum

PURPOSE

This study was designed to evaluate rectocele repair using collagen mesh.

METHODS

32 female patients underwent surgical repair using collagen mesh. Outcome was assessed in 29 patients and preoperative assessment included standardized questionnaire, clinical examination, and defecography. At the six-month follow-up, patients answered a standardized questionnaire and underwent clinical examination. At the 12-month follow-up, patients answered a standardized questionnaire, underwent clinical examination, and defecography.

RESULTS

Preoperatively, 26 patients had a Stage II and 3 patients had a Stage III rectocele. At the 6-month follow-up, five patients had rectocele ≥ Stage II (P < 0.001) and at the 12-month follow-up, seven patients had rectocele ≥ Stage II (P < 0.001) at clinical examination. At the preoperative defecography, all patients presented a rectocele. At the 12-month defecography, 14 patients had no rectocele (P < 0.001) and 15 had a rectocele. At the six-month follow-up, there was a significant decrease in rectal emptying difficulties, need of digital support of the posterior vaginal wall at defecation, and defecation frequency. At the 12-month follow-up, symptom improvement remained, but was less pronounced.

CONCLUSIONS

Rectocele repair using collagen mesh improved anatomic support, but there is a substantial risk for recurrence with unsatisfactory anatomic and functional outcome one year after surgery. Rectocele repair using mesh was not associated with an increased risk of dyspareunia. Rectocele repair using biomaterial mesh reinforcement needs further evaluation before adopted into clinical practice.

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Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Pelvic Floor Center, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden

    Daniel Altman M.D., Jan Zetterström M.D., Ph.D., Annika López M.D., Ph.D., Bo Anzén M.D., Ph.D. & Christian Falconer M.D., Ph.D.

  2. Division of Surgery, Pelvic Floor Center, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden

    Fredrik Hjern M.D.

  3. Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, Minnesota

    Anders Mellgren M.D., Ph.D.

Authors
  1. Daniel Altman M.D.
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  2. Jan Zetterström M.D., Ph.D.
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  3. Annika López M.D., Ph.D.
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  4. Bo Anzén M.D., Ph.D.
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  5. Christian Falconer M.D., Ph.D.
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  6. Fredrik Hjern M.D.
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  7. Anders Mellgren M.D., Ph.D.
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Correspondence to Daniel Altman M.D..

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Altman, D., Zetterström, J., López, A. et al. Functional and Anatomic Outcome After Transvaginal Rectocele Repair Using Collagen Mesh: A Prospective Study. Dis Colon Rectum 48, 1233–1242 (2005). https://doi.org/10.1007/s10350-005-0023-y

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