Horizontal versus vertical plication of the rectovaginal septum in transperineal repair of anterior rectocele: a pilot randomized clinical trial

Aim Anterior rectocele is usually an asymptomatic condition in many women, yet it can be associated with obstructed defaecation syndrome (ODS). Transperineal repair of rectocele (TPR) has been followed by variable rates of improvement in ODS. The present pilot randomized clinical trial aimed to eval...

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Bibliographic Details
Published in:Colorectal disease 2021-04, Vol.23 (4), p.923-931
Main Authors: Omar, Waleed, Elfallal, Ahmed Hossam, Emile, Sameh Hany, Elshobaky, Ayman, Fouda, Elyamani, Fathy, Mohammad, Youssef, Mohamed, El‐Said, Mohamed
Format: Article
Language:English
Subjects:
Clinical trials
horizontal
plication
randomized trial
rectocele
Septum
transperineal repair
vertical
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Summary:Aim Anterior rectocele is usually an asymptomatic condition in many women, yet it can be associated with obstructed defaecation syndrome (ODS). Transperineal repair of rectocele (TPR) has been followed by variable rates of improvement in ODS. The present pilot randomized clinical trial aimed to evaluate the outcome of TPR with vertical plication (VP) of the rectovaginal septum compared to horizontal plication (HP). Methods Adult women with anterior rectocele were recruited to the study and were randomly allocated to one of two equal groups. The first group underwent TPR with VP of the rectovaginal septum and the second group underwent TPR with HP. The main outcome measures were improvement in ODS, recurrence of rectocele, complications and dyspareunia. Results The trial included 40 female patients with anterior rectocele. There was no significant difference between the two groups regarding the postoperative Wexner score. Complete cure and significant improvement in ODS symptoms were comparable after the two techniques. The reduction in rectocele size after HP was significantly greater than after VP (1.7 vs. 2.6, P 
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.15483