J Korean Soc Coloproctol.  2002 Aug;18(4):216-221.

The Prospective Study of Anorectal Physiologic Change after Transanal Repair in Rectocele

• Kim JH
• Kwon YM
• Lee YP

Abstract

PURPOSE: Generally, the constipation is a medical disease, but recently, there are many reports showing the good results after correction of rectocele in constipated patients. The authors try to show the effect of surgery in rectocele cases and also analyse the relationship between the anatomical distortion and clinical symptoms by using anorectal physiologic study before and after operation.
METHODS
31 cases of rectocele are surgically corrected from June 1998 to August 2001. 31 cases of them could be followed up and with them, pre- and post-operative anal ultrasonography, anorectal manommetry and defecography were tried. Personal interview was also done to each patient.
RESULTS
After trasanal rectocele repair, the rectocele size decreased and clinical symptoms improved remarkably. In defecography, anorectal angle (pre-op; 105.9+/-6.0 degrees vs. post-op; 109.5+/-3.7 degees) and perineal descent (1.6+/-0.7 cm vs. 2.4+/-1.2 cm) increase in pushing state after operation. In anorectal manometry, mean resting anal pressure (29.2+/- 3.4 mmHg vs. 17.9+/-4.6 mmHg) and maximal squeeze pressure (84.5+/-20.8 mmHg vs. 47.6+/-12.1 mmHg) decreased and rectal sensation improved after operation.
CONCLUSIONS
Current results suggest that the surgical correction aims not only the decrement of the rectocele size but changing the vector power on pushing more physiologically and also improving the rectal sensibility.

MeSH Terms

Constipation
Defecography
Humans
Manometry
Prospective Studies*
Rectocele*
Sensation
Ultrasonography