ABSTRACT
BACKGROUND: This study was conducted to investigate the results of rectovaginovesicopexy (RVVP) in patients with combined defaecation and micturition disorders. RVVP was developed from a standard procedure for different forms of defaecation disorders (the rectovaginopexy (RVP)). It is only a limited extension to the RVP and results in elevation of all three pelvic compartments. METHODS: In a consecutive series of 25 patients the effects or RVVP were evaluated prospectively. Information about the clinical history and results was obtained by a standard questionnaire filled out before and 3 and 12 months after operation. Dynamic defaecography was performed before and 3 months after RVVP. Before operation urodynamic studies were conducted. RESULTS: RVVP improved constipation (14 of 18 patients improved, P = 0.001), faecal incontinence (11 of 16 patients improved, P = 0.005) and dysfunctional voiding (ten of 16 patients improved, P = 0.07) without induction of these disorders. Overall urinary incontinence improved in 11 of 22 patients (P = 0.18), with deterioration of urinary incontinence in three and induction of urinary incontinence in two of the patients. Patients with isolated urinary stress incontinence fared better (eight of 13 patients improved) than those with mixed urinary incontinence. CONCLUSION: RVVP provides satisfactory improvement of combined defaecation and micturition disorders. The benefits of a limited extension of the RVP seem to outweigh potential side-effects such as deterioration or de novo defaecation or micturition disorders.
Subject(s)
Constipation/surgery , Fecal Incontinence/surgery , Urination Disorders/surgery , Adult , Aged , Constipation/physiopathology , Fecal Incontinence/physiopathology , Female , Humans , Male , Middle Aged , Pilot Projects , Polytetrafluoroethylene , Prospective Studies , Rectum/surgery , Suture Techniques , Treatment Outcome , Urination Disorders/physiopathology , Urodynamics , Vagina/surgeryABSTRACT
Abdominal-retroperitoneal sacral genito-colpopexy using the expanded polytetrafluoroethylene (ePTFE) soft tissue patch has been found to be highly effective for repair of genito-vaginal prolapse. We treated 61 patients in this way, including patients who had failed multiple previous attempts at repair. At a mean of 32 months of follow-up, more than 95% of patients were still classified as successfully treated. To preserve the uterus in cases of complete genito-vaginal prolapse, we have developed a new surgical technique, which we describe in this paper.
