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Higher symptom score, larger residual rectocele, and lower rectal compliance predict failure of improvement after surgical treatment of rectocele
Emile, Sameh Hany; Elfallal, Ahmed Hossam; Abdelnaby, Mahmoud; Balata, Mohamed.
  • Emile, Sameh Hany; Mansoura University. Mansoura University Hospitals. Department of General Surgery. Mansoura. EG
  • Elfallal, Ahmed Hossam; Mansoura University. Mansoura University Hospitals. Department of General Surgery. Mansoura. EG
  • Abdelnaby, Mahmoud; Mansoura University. Mansoura University Hospitals. Department of General Surgery. Mansoura. EG
  • Balata, Mohamed; Mansoura University. Mansoura University Hospitals. Department of General Surgery. Mansoura. EG
J. coloproctol. (Rio J., Impr.) ; 42(3): 245-250, July-Sept. 2022. tab
Article Dans Anglais | 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)
Sujets)


Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Résultat thérapeutique / Rectocèle / Évaluation des symptômes Type d'étude: Etude diagnostique / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: J. coloproctol. (Rio J., Impr.) Thème du journal: Cirurgia / Doen‡as Retais / Doen‡as do Colo / Gastroentérologie / Cirurgia Année: 2022 Type: Article Pays d'affiliation: Égypte Institution/Pays d'affiliation: Mansoura University/EG

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Résultat thérapeutique / Rectocèle / Évaluation des symptômes Type d'étude: Etude diagnostique / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: J. coloproctol. (Rio J., Impr.) Thème du journal: Cirurgia / Doen‡as Retais / Doen‡as do Colo / Gastroentérologie / Cirurgia Année: 2022 Type: Article Pays d'affiliation: Égypte Institution/Pays d'affiliation: Mansoura University/EG