Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair
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ORIGINAL ARTICLE
Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair Sameh Hany Emile 1,2 & Mohammed Balata 1 & Waleed Omar 1 & Wael Khafagy 1 & Hesham Elgendy 1 Received: 11 May 2020 / Accepted: 9 July 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis The present study aimed to assess the changes in manometric parameters after transperineal repair (TPR) of rectocele and interpret failure of symptom improvement in light of these changes. Methods This was an observational cohort study on patients with anterior rectocele who underwent TPR in the period of February 2016 to February 2019. Data collected included patients’ demographics, rectocele size, Wexner constipation and incontinence scores, anal pressures, and rectal sensation before and 12 months after TPR. Analysis of data was done by paired t-test and chi-square test. Results Forty-six female patients with a mean age of 43.2 ± 10.7 years were included. After a mean follow-up of 13.9 ± 2.7 months, 30 (65.2%) patients reported clinical improvement and 16 (34.8%) had no significant improvement. At 12 months after rectocele repair, the entire cohort studied showed an insignificant increase in the mean anal pressures and a significant decrease in the thresholds of first rectal sensation, first urge, intense urge, and maximum tolerable volume (MTV). Patients who clinically improved showed similar physiologic changes to the entire cohort examined, whereas patients who had no clinical improvement showed significant increases in the mean anal pressures and insignificant decreases in rectal sensation and MTV. Conclusion Patients who showed clinical improvement showed insignificant increases in anal pressures and significant decreases in thresholds of first rectal sensation, first urge, intense urge, and MTV. Contrarily, patients who did not show clinical improvement showed significant increases in anal pressures and insignificant reduction in sensory thresholds. Keywords Rectocele . Transperineal . Repair . Anorectal . Vaginal prolapse . Manometry
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-020-04444-9) contains supplementary material, which is available to authorized users. * Sameh Hany Emile [email protected] Mohammed Balata [email protected] Waleed Omar [email protected] Wael Khafagy [email protected] Hesham Elgendy [email protected] 1
Colorectal Surgery Unit, General Surgery Department, Mansoura faculty of medicine, Mansoura University, Mansoura city, Egypt
2
General Surgery Department, Faculty of Medicine, Mansoura University Hospitals, Elgomhuoria Street, Mansoura city, Egypt
Introduction Anterior rectocele is a herniation of the anterior rectal wall through the posterior vaginal wall. Some investigators consider rectocele a prolapse of the posterior vaginal wall that may occur along with other pelvic support defects in a condition referred to as pelvic organ prolapse (POP)
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