Outcomes after the repair of rectoceles with transperineal insertion of a bioprosthetic graft.

Abstract

This study was performed to determine the early outcomes with the use of bioprosthetic grafts for the management of rectoceles and to compare them to those achieved with transanal techniques. A retrospective analysis of prospectively collected data was performed for patients treated for a rectocele. Data collected included age, technique of repair, complications, and functional outcomes. Defecatory function was determined using the Birmingham Bowel and Urinary Symptoms Questionnaire, a validated instrument for the measurement of bowel symptoms. The questionnaire was administered preoperatively and at 12 weeks and 12 months postoperatively. In this series, 88 women underwent a transanal repair, compared to 32 women who had their rectocele managed with a bioprosthetic graft. After 1 year of follow-up, patients whose rectocele was repaired using a bioprosthetic had significantly fewer complications with comparable functional results between the 2 techniques. These data suggest that transperineal, bioprosthetic repair of rectoceles is associated with similar functional results but fewer complications when compared to transanal techniques during the early postoperative period. Randomized studies with longer-term follow-up will be required before the role of bioprosthetic repair of rectoceles can be determined.