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01 February 2017 : Clinical Research  

Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

Yang Shi1BCE, Yongjun Yu1CD, Xipeng Zhang1ABEF*, Yuwei Li1AF

DOI: 10.12659/MSM.898790

Med Sci Monit 2017; 23:598-605

Abstract

BACKGROUND: The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele.

MATERIAL AND METHODS: Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups.

RESULTS: Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery.

CONCLUSIONS: For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR.

Keywords: Anal Canal - surgery, Constipation - surgery, Defecography, Digestive System Surgical Procedures - methods, Intestinal Obstruction - surgery, operative time, Postoperative Complications, Prospective Studies, Rectocele - surgery, Rectum - surgery, Surgical Mesh

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750