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Role of defecography in predicting clinical outcome of rectocele repair

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

PURPOSE: The aim of this study was to evaluate the role of defecography in predicting clinical outcome of rectocele repair. METHODS: Between January 1988 and July 1994, 74 consecutive patients (median age, 54 (range, 35–81) years) with a rectocele and symptoms of obstructed defecation were studied prospectively. After preoperative evaluation by a standardized questionnaire, physical examination, and defecography, a combined transvaginal/transanal rectocele repair was performed. At follow-up, all patients had defecography. Long-term results were qualified by an independent observer after a median follow-up of 58 (range, 14–89) months as “excellent,” “good,” or “poor.” RESULTS: Rectocele repair was considered excellent in 37 patients and good in 13 patients. Defecography six months after surgery did not show persistent or recurrent rectocele in any of the patients. Size of the rectocele, barium-trapping in the rectocele, internal intussusception, rectal evacuation, and perineal descent did not appear to influence clinical outcome. Radiologic evidence of anismus did not correlate with longterm results of rectocele repair. CONCLUSIONS: Combined transanal/transvaginal repair of rectocele is an efficient therapy in patients with obstructed defecation. Various defecographic parameters (size of rectocele, internal intussusception, rectal evacuation, perineal descent, radiologic signs of anismus) do not appear to influence clinical outcome of surgery. The main value of defecography is the objective demonstration of rectocele and any associated abnormalities such as an enterocele preoperatively and again in objective assessment of the postoperative results.

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Authors and Affiliations

  1. Department of General Surgery, University Hospital Dijkzigt, dr Molewaterplein 40, 3015, GD Rotterdam, The Netherlands

    J. H. van Dam M.D., M. J. Gosselink M.D., H. J. Bonjer M.D., Ph.D. & W. R. Schouten M.D., Ph.D.

  2. Department of Radiology, University Hospital Dijkzigt, Rotterdam, The Netherlands

    A. Z. Ginai M.D., Ph.D.

  3. Department of Gynecology, University Hospital Dijkzigt, Rotterdam, The Netherlands

    W. M. Huisman M.D., Ph.D.

  4. Department of Biostatistics, University Hospital Dijkzigt, Rotterdam, The Netherlands

    W. C. J. Hop Ms.C.

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  1. J. H. van Dam M.D.
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  2. A. Z. Ginai M.D., Ph.D.
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  3. M. J. Gosselink M.D.
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  4. W. M. Huisman M.D., Ph.D.
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  5. H. J. Bonjer M.D., Ph.D.
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  6. W. C. J. Hop Ms.C.
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van Dam, J.H., Ginai, A.Z., Gosselink, M.J. et al. Role of defecography in predicting clinical outcome of rectocele repair. Dis Colon Rectum 40, 201–207 (1997). https://doi.org/10.1007/BF02054989

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