To Analyze the Outcome of Vaginal Reconstructive Surgery for Isolated Rectocele

Aim: The present study highlights the symptomatic relief of local and bowel symptoms after vaginal reconstructive surgery for isolated rectocele.

Introduction: Owing to multiparity, long-term constipation, a sedentary lifestyle, and poor lifestyle choices, isolated posterior compartment defect, also known as isolated rectocele, is increasing. Herniation of the rectum into the vaginal canal is referred to as a rectocele. Difficulty in defecating, constipation, incomplete evacuation, pressure in the rectovaginal area, and manual vaginal replacement during evacuation were the symptoms associated with the posterior wall defect. The cases with isolated rectocele were evaluated and relief of local and bowel functions before and after the pelvic repair were assessed.

Materials and Methods: A prospective study was done between August 2016-August 2018, for the period of 2 years at IIMSR, Dasauli, dept. of OBG, Lucknow wherein cases with isolated rectocele were identified and pelvic repair of the rectocele was done by repair of pararectal fascia without mesh along with pelvic floor repair wherein the medial fibres of levator ani was approximated. Out of 426 cases presenting to the Gynecology outpatient department with mass per vagina, local pressure symptoms, after detailed history and examination, 25 cases of isolated rectocele were included in the study.

Results: A total of 25 cases out of 426(5.86%) were with isolated rectocele.25 cases underwent pelvic repair of the rectocele by repair of pararectal fascia without mesh, excision of redundant vagina along with pelvic floor repair with approximation of medial fibres of levator ani muscles. There was a significant association between isolated rectocele, chronic constipation and multi-parity. The statistical analysis was done using chi-square and p value.

Conclusion: The clinicians will need to be well versed in proper evaluation and the operative techniques to manage the defects. More research is needed to be done to understand the correlation between anatomic defect and functional derangement that occurs secondary to posterior wall prolapse.