Abstract
In order to ascertain whether plastic surgery for rectocele is of value in the treatment of outlet obstruction, a retrospective study was made of 21 women complaining of difficulty in expelling faeces: 13 patients (group A) underwent surgery with transanal longitudinal plication of the anterior rectal wall (Block's technique), and 8 patients (group B) had colpoperineoplasty which, in 2, was associated with bladder-neck suspension following the Raz-Peyrera technique for urinary incontinence. The mean follow-up was 24.2±18.7 and 36.8±17.8 months respectively. In 11 group A patients (80.9%) and 6 group B patients (75%) cure, or an improvement, was achieved. Of the remaining 4 patients (19%), recurrent rectocele was found in 2 (one group A and one group B) and intestinal transit time tests detected colonic constipation in one group A and in one group B patient. It is concluded that surgery can resolve outlet obstruction from rectocele, but Block's technique is preferable because it is more straight-forward and easier.
Résumé
Afin de déterminer l'utilité d'une correction chirurgicale plastique des rectocèles dans le traitement des dyschézies, une étude rétrospective portant sur 21 femmes se plaignant de difficultés d'exonération a été entreprise: 13 patientes (groupe A) ont subi une plicature longitudinale transanale de la paroi antérieure du rectum (technique de Block) et 8 patients (groupe B) ont subi une colpo-périnéoplastie associée chez deux malades à une suspension du col de la vessie selon la technique de Raz-Peyrera pour incontinence urinaire. Le suivi moyen était respectivement de 24,2±18,7 et 36,8±17,8 mois. Chez 11 patients du groupe A (80,9%) et 6 patientes du groupe B (75%), la guérison ou une amélioration a été obtenue. Chez les autres 4 patientes (19%), une récidive de la rectocèle a été observée 2 reprises (une fois dans chaque groupe) et une constipation d'origine colique démontrée par un temps de transit intestinal a été mise en évidence chez un malade du groupe A et un malade de groupe B. Nous concluons de cette étude que la chirurgie peut guérir la dyschézie résultant d'une rectocèle et que la technique de Block est préférable parce qu'elle donne de mailleurs résultats et est plus facile à réaliser.
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Infantino, A., Masin, A., Melega, E. et al. Does surgery resolve outlet obstruction from rectocele?. Int J Colorect Dis 10, 97–100 (1995). https://doi.org/10.1007/BF00341206
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DOI: https://doi.org/10.1007/BF00341206