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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Randomized controlled trial between perineal and anal repairs of rectocele in obstructed defecation
World Journal of Surgery, Volume 34, No. 4, Year 2010
Notification
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Description
Objective The present study was designed to evaluate functional outcome of perineal repair with and without levatorplasty versus transanal repair of rectocele in obstructed defecation. Methods and patients A total of 48 multiparous women with obstructed defecation caused by a rectocele were randomly allocated to three groups: transperineal repair with levatorplasty (TPR-LP; n = 16); transperineal repair without levatorplasty (TPR; n = 16); and transanal repair (TAR; n = 16). The study included defecographic assessment, anal manometry, symptom improvement, sexual function, and score on a function questionnaire. Assessments were done preoperatively and 6 months postop-eratively. Results Defecography showed significant reduction in size of rectocele in all groups. Constipation improved significantly in both groups with transperineal repair but not in the group with transanal repair. Significant reductions in mean anal resting pressure, maximum reflex volume, and urge-to-defecate volume were observed only with the transperineal approach (with and without levatorplas-ty). Functional score improved significantly in the transperineal groups (with levatorplasty, P < 0.001; without levatorplasty, P < 0.01), but not in the transanal group (P = 0.142). Levatorplasty added to transperineal repair significantly improved the overall functional score compared with transperineal repair alone (P < 0.01) and transanal repair TAR (P < 0.001). Conclusions Rectocele repair appears to improve ano-rectal function by improving rectal urge sensitivity. Transperineal repair of rectocele is superior to transanal repair in both structural and functional outcome. Lev-atorplasty improves functional outcome, but potential effects on dyspareunia should be discussed with the patient. © Société Internationale de Chirurgie 2010.
Authors & Co-Authors
Farid, Mohamed E.
Egypt, Mansoura
Faculty of Medicine
Madboulay, Khaled
Egypt, Alexandria
Faculty of Medicine
Hussein, Ahmed M.
Egypt, Alexandria
Faculty of Medicine
Mahdy, Tarek
Egypt, Mansoura
Faculty of Medicine
Moneim, H. A.
Egypt, Mansoura
Faculty of Medicine
Omar, Waleed H.
Egypt, Mansoura
Faculty of Medicine
Statistics
Citations: 57
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1007/s00268-010-0390-y
ISSN:
03642313
e-ISSN:
14322323
Research Areas
Health System And Policy
Sexual And Reproductive Health
Study Approach
Quantitative
Participants Gender
Female