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Erschienen in: Journal of Gastrointestinal Surgery 2/2017

24.10.2016 | Original Article

Comparative Study Between Trans-perineal Repair With or Without Limited Internal Sphincterotomy in the Treatment of Type I Anterior Rectocele: a Randomized Controlled Trial

verfasst von: Mohamed Youssef, Sameh Hany Emile, Waleed Thabet, Hossam Ayman Elfeki, Alaa Magdy, Waleed Omar, Wael Khafagy, Mohamed Farid

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 2/2017

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Abstract

Background and Aim

Two types of rectocele exist; type I is characterized by relatively high resting anal pressures, whereas type II has lower resting anal pressures with associated pelvic organ prolapse. We compared trans-perineal repair (TPR) of rectocele with or without limited internal sphincterotomy (LIS) in the treatment of type I anterior rectocele.

Patients and Interventions

Consecutive patients with anterior rectocele were evaluated for inclusion. Sixty-two female patients with type I anterior rectocele were randomized and equally allocated to receive TPR alone (group I) or TPR with LIS (group II). The primary outcome was the clinical improvement of constipation. Secondary outcomes were recurrence of rectocele, operative time, and postoperative complications including fecal incontinence (FI).

Results

Clinical improvement of constipation and patients’ satisfaction were significantly higher in group II at 1 year of follow-up (93.3 versus 70 %). Constipation scores significantly decreased in both groups postoperatively with more reduction being observed in group II (11.1 ± 2.1 in group I versus 8 ± 1.97 in group II). Significant reduction in the resting anal pressure was noticed in group II. Recurrence was recorded in three (10 %) patients of group I and one patient of group II. No significant differences between the two groups regarding the operative time and hospital stay were noted.

Conclusion

Adding LIS to TPR of type I rectocele achieved better clinical improvement than TPR alone. The only drawback of LIS was the development of a minor degree of FI, which was temporary in duration.
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Metadaten
Titel
Comparative Study Between Trans-perineal Repair With or Without Limited Internal Sphincterotomy in the Treatment of Type I Anterior Rectocele: a Randomized Controlled Trial
verfasst von
Mohamed Youssef
Sameh Hany Emile
Waleed Thabet
Hossam Ayman Elfeki
Alaa Magdy
Waleed Omar
Wael Khafagy
Mohamed Farid
Publikationsdatum
24.10.2016
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 2/2017
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3299-4

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