Higher symptom score, larger residual rectocele, and lower rectal compliance predict failure of improvement after surgical treatment of rectocele
J. coloproctol. (Rio J., Impr.)
;
42(3): 245-250, July-Sept. 2022. tab
Artículo
en Inglés
| LILACS
| ID: biblio-1421980
ABSTRACT
Background: Rectocele is a frequent finding in women and is usually asymptomatic. However, it is sometimes associated with symptoms of obstructed defecation syndrome (ODS). While most patients with ODS due to rectocele respond well to conservative treatment, some may require surgical treatment. The aim of the study was to determine the predictors of failure of symptom improvement after rectocele repair. Methods: The study included adult women with rectocele who underwent surgical treatment by transperineal repair (TPR) or transvaginal repair (TVR). The preoperative and postoperative assessment was done using the Wexner constipation score, anorectal manometry, and defecography. Results: A total of 93 female patients with a mean age of 43.7 years were included. Among them, 65.6% of patients underwent TPR and 34.4% underwent TVR; 22 (23.7%) patients reported failure of significant improvement in ODS symptoms after surgery. The independent predictors of failure of improvement were higher preoperative Wexner score (odds ratio, OR: 1.4, 95% confidence interval, CI: 1.09-1.84, p = 0.009), larger residual rectocele after repair (OR: 2.95, 95% CI: 1.43-6.08, p = 0.003), and lower postoperative maximum tolerable volume (OR: 0.949, 95% CI: 0.907-0.992, p = 0.02). The predictive cutoff point for the preoperative Wexner score was 15. Conclusions: Patients with a preoperative Wexner score higher than 15 and larger residual rectocele after surgery may experience little improvement in symptoms after rectocele repair. Although TPR was associated with a poorer relief of symptoms than did TVR; it was not an independent predictor of failure. (AU)
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Resultado del Tratamiento
/
Rectocele
/
Evaluación de Síntomas
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Femenino
/
Humanos
Idioma:
Inglés
Revista:
J. coloproctol. (Rio J., Impr.)
Asunto de la revista:
Cirurgia
/
Doenas Retais
/
Doenas do Colo
/
Gastroenterologia
/
Cirurgia
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
Egipto
Institución/País de afiliación:
Mansoura University/EG
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