TY - JOUR
T1 - Symptomatic rectocele
T2 - What are the indications for repair?
AU - Hall, Glenn M.
AU - Shanmugan, Skandan
AU - Nobel, Tamar
AU - Paspulati, Raj
AU - Delaney, Conor P.
AU - Reynolds, Harry L.
AU - Stein, Sharon L.
AU - Champagne, Bradley J.
PY - 2014/3
Y1 - 2014/3
N2 - Background The surgical indications for symptomatic rectocele are undefined, and surgery has high recurrence rates. We implemented magnetic resonance imaging defecography (MRID) to determine if utilizing strict inclusion criteria for rectocele repair improves outcomes. Methods Patients with obstructive defecation syndrome (ODS) who underwent dynamic MRID were evaluated. Indications for surgical repair were defecation requiring manual assistance and the following MRID results: anterior defect >2 cm, incomplete evacuation, and the absence of perineal descent. Primary outcomes were the change in quality of life (QOL) scores and recurrence. Results From 2006 to 2013, 143 patients who presented with ODS underwent MRID. Seventeen patients met the criteria for repair. Recurrence was low (5.8%) with a median follow-up of 23 months, QOL scores improved from 57.3 to 76.5 (P =.041). Conclusions A minority of patients (12%) with ODS met the above criteria for rectocele repair. Patients who underwent repair had a significant improvement in QOL and low recurrence rate.
AB - Background The surgical indications for symptomatic rectocele are undefined, and surgery has high recurrence rates. We implemented magnetic resonance imaging defecography (MRID) to determine if utilizing strict inclusion criteria for rectocele repair improves outcomes. Methods Patients with obstructive defecation syndrome (ODS) who underwent dynamic MRID were evaluated. Indications for surgical repair were defecation requiring manual assistance and the following MRID results: anterior defect >2 cm, incomplete evacuation, and the absence of perineal descent. Primary outcomes were the change in quality of life (QOL) scores and recurrence. Results From 2006 to 2013, 143 patients who presented with ODS underwent MRID. Seventeen patients met the criteria for repair. Recurrence was low (5.8%) with a median follow-up of 23 months, QOL scores improved from 57.3 to 76.5 (P =.041). Conclusions A minority of patients (12%) with ODS met the above criteria for rectocele repair. Patients who underwent repair had a significant improvement in QOL and low recurrence rate.
KW - Magnetic resonance imaging defecography (MRID)
KW - Obstructive defecation syndrome (ODS)
KW - Rectocele
KW - Stapled transanal rectal resection (STARR)
UR - http://www.scopus.com/inward/record.url?scp=84895472310&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2013.12.002
DO - 10.1016/j.amjsurg.2013.12.002
M3 - Article
C2 - 24444857
AN - SCOPUS:84895472310
SN - 0002-9610
VL - 207
SP - 375
EP - 379
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -