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Enterocele is correctable using the Ripstein rectopexy

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

PURPOSE: About one-third of the patients with rectal prolapse or rectal intussusception have concurrent enterocele at defecography. The purpose of this study was to evaluate the effect of the Ripstein procedure on the concurrent enterocele and to study the outcome of the procedure with respect to the patients' symptoms. METHODS: Twenty-two patients with enterocele and either rectal prolapse or rectal intussusception at defecography were treated using the Ripstein procedure. Postoperatively, the patients were evaluated with clinical examination (22 patients) and defecography (16 patients). RESULTS: None of the patients had recurrence of enterocele, rectal prolapse, or intussusception at postoperative follow-up. Continence was improved in 15 of 16 incontinent patients. Emptying difficulties were unchanged in eight patients, improved in five patients, and had deteriorated in four patients. CONCLUSIONS: Enterocele is corrected by using the Ripstein rectopexy. Persisting defecation difficulties after the Ripstein procedure are unlikely to be secondary to enterocele. The Ripstein procedure can be an alternative in the treatment of enterocele, as a majority of these patients also have rectal prolapse or rectal intussusception.

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References

  1. Ranney B. Enterocele, vaginal prolapse, pelvic hernia: recognition and treatment. Am J Obstet Gynecol 1981;140:53–61.

    PubMed  Google Scholar 

  2. Kelvin FM, Maglinte DD, Hornback JA, Benson JT. Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 1992;184:547–51.

    PubMed  Google Scholar 

  3. Brodén B, Snellman B. Procidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism. Dis Colon Rectum 1968;11:330–47.

    PubMed  Google Scholar 

  4. Ekberg O, Nylander G, Fork FT. Defecography. Radiology 1985;155:45–8.

    Google Scholar 

  5. Karulf RE, Coller JA, Bartolo DC,et al. Anorectal physiology testing: a survey of availability and use. Dis Colon Rectum 1991;34:464–8.

    Article  PubMed  Google Scholar 

  6. Johansson C, Ihre T, Ahlbäck SO. Disturbances in the defecation mechanism with special reference to intussusception of the rectum (internal procidentia). Dis Colon Rectum 1985;28:920–4.

    PubMed  Google Scholar 

  7. Ripstein CB. Surgical care of massive rectal prolapse. Dis Colon Rectum 1965;8:34–8.

    Google Scholar 

  8. Ahlbäck S, Brodén B, Brodén G, Ewerth S, Holmström B. Rectal anatomy following Ripstein's operation for prolapse studied by cineradiography. Dis Colon Rectum 1979;22:333–5.

    PubMed  Google Scholar 

  9. Holmström B, Dolk A. Rectal prolapse: rectopexy using synthetic circular net (Ripstein's operation). In: Fielding LP, Goldberg SM, eds. Surgery of the colon, rectum and anus. 5th ed. London: Butterworth-Heineman Ltd., 1993:706–11.

    Google Scholar 

  10. Holmström B, Brodén G, Dolk A. Results of the Ripstein operation in the treatment of rectal prolapse and internal rectal procidentia. Dis Colon Rectum 1986;29:845–8.

    Google Scholar 

  11. Addison WA, Livengood C, Sutton GP, Parker RT. Abdominal sacral colpopexy with Mersilene mesh in the retroperitoneal position in the management of posthysterectomy vaginal vault prolapse and enterocele. Am J Obstet Gynecol 1985;153:140–6.

    PubMed  Google Scholar 

  12. Holland J. Enterocele and prolapse of the vaginal vault. Clin Obstet Gynecol 1972;15:1145–54.

    PubMed  Google Scholar 

  13. Timmons MC, Addison WA, Addison SB, Cavenar MG. Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault prolapse and enterocele. Evolution of operative techniques. J Reprod Med 1992;37:323–7.

    PubMed  Google Scholar 

  14. Nichols DH, Randall CL. Vaginal Surgery. 3rd ed. Baltimore: Williams & Wilkins, 1989.

    Google Scholar 

  15. Zacharin RF, Hamilton NT. Pulsion enterocele: long-term results of an abdominoperineal technique. Obstet Gynecol 1980;55:141–8.

    PubMed  Google Scholar 

  16. Symmonds RE, Williams TJ, Lee RA, Webb MJ. Posthysterectomy enterocele and vaginal vault prolapse. Am J Obstet Gynecol 1981;140:852–9.

    PubMed  Google Scholar 

  17. Nichols DH. Surgery for pelvic floor disorders. Surg Clin North Am 1991;71:927–46.

    PubMed  Google Scholar 

  18. Moschowitz AV. The pathogenesis, anatomy and cure of prolapse of the rectum. Surg Gynecol Obstet 1912;15:7–21.

    Google Scholar 

  19. Halban J. Gynäkologische Operationslehre. Berlin: Urban and Schwarzenberg, 1932.

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden

    Anders Mellgren M.D., Anders Dolk M.D., Claes Johansson M.D. & Bo Holmström M.D.

  2. Department of Diagnostic Radiology, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden

    Staffan Bremmer M.D.

  3. Departments of Gynecology and Obstetrics, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden

    Bo Anzén M.D.

Authors
  1. Anders Mellgren M.D.
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  2. Anders Dolk M.D.
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  3. Claes Johansson M.D.
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  4. Staffan Bremmer M.D.
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  5. Bo Anzén M.D.
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  6. Bo Holmström M.D.
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Mellgren, A., Dolk, A., Johansson, C. et al. Enterocele is correctable using the Ripstein rectopexy. Dis Colon Rectum 37, 800–804 (1994). https://doi.org/10.1007/BF02050145

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  • DOI: https://doi.org/10.1007/BF02050145

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