Résumé
L’utilisation des prothèses synthétiques dans la chirurgie de la statique pelvienne est en plein essor. Pour les chirurgiens, l’inquiétude majeure concerne les complications secondaires à l’utilisation de ces matériaux. La compression rectale, encore jamais décrite dans la littérature, en fait partie. Nous rapportons trois cas de compressions rectales après mise en place d’une prothèse prérectale par voie vaginale. Des symptômes anorectaux étaient présents à 9,7 ± 4 mois (5–12) postopératoires. Le diagnostic étiologique a été retardé à 21 ± 12 mois (9–33). Le toucher rectal est essentiel au diagnostic. L’échographie périnéale, la défécographie ou l’IRM dynamique complètent les données cliniques. La décompression chirurgicale est toujours efficace. La compression rectale peut être une complication des cures de prolapsus par prothèse prérectale type Transvaginal Mesh qu’il faut savoir diagnostiquer, traiter et prévenir.
Abstract
The employment of synthetic implants in the surgery of pelvic stasis is expanding rapidly. For surgeons, the main anxiety is that of complications resulting from the use of these materials. Rectal compression is one of these, though it has not yet been described in the literature. We report three cases of rectal compression after positioning a pre-rectal implant via a vaginal approach. Anorectal symptoms were present at 9.7 ± 4 months (5–12) postsurgery. Diagnosis was delayed by 21 ± 12 months (9–33). Rectal examination is essential to make the diagnosis. Perineal ultrasound, defecography, and dynamic MRI provide further information. Surgical decompression is always effective. Rectal compression can complicate treatment of prolapse using pre-rectal transvaginal mesh types of implant. It is necessary to know how to diagnose this, and how to treat and prevent it.
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Emmanuelli, V., Rubod, C., Poncelet, E. et al. Cure de rectocèle par prothèse type Transvaginal Mesh et compression rectale: à propos de trois cas. Pelv Perineol 5, 243–246 (2010). https://doi.org/10.1007/s11608-010-0357-3
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DOI: https://doi.org/10.1007/s11608-010-0357-3