To study the outcome of vaginal reconstructive surgery for isolated rectocele

Abstract

Aim: To study the symptomatic relief of local and bowel symptoms after vaginal reconstructive surgery for isolated rectocele. Introduction: Isolated posterior compartment defect as isolated rectocele is on the raise due to multi parity and chronic constipation, sedentary and faulty lifestyle. The term rectocele means herniation of rectum into vaginal canal. The posterior wall defect presented with difficult defecation, constipation, incomplete evacuation, pressure in recto vaginal area, manual vaginal replacement during evacuation.The cases with isolated rectocele were evaluated and relief of local and bowel functions before and after the pelvic repair were assessed. Materials and Methods: A prospective study was done between August 2016-August 2018, for the period of 2 years at IIMSR, Dasauli, dept. of OBG, Lucknow wherein cases with isolated rectocele were identified and pelvic repair of the rectocele was done by repair of pararectal fascia without mesh along with pelvic floor repair wherein the medial fibres of levator ani was approximated. Out of 426 cases presenting to the gynaecology OPD with mass per vagina, local pressure symptoms, after detailed history and examination, 25 cases of isolated rectocele were included in the study. Result: A total of 25 cases out of 426(5.86%) were with isolated rectocele.25 cases underwent pelvic repair of the rectocele by repair of pararectal fascia without mesh,excision of redundant vagina along with pelvic floor repair with approximation of medial fibres of levator ani muscles. There was significant association between isolated rectocele, chronic constipation and multi parity. The statistical analysis was done using chi square and pvalue. Keywords: Isolated rectocele, Chronic constipation, Pelvic repair.