ENDORECTAL REPAIR OF RECTOCELE REVISITED

Background Transanal repair of rectocele involving the suprasphincteri c portion of the rectovaginal septum has been shown to provide excelle nt results in up to 90 per cent of cases. Selection of patients suitab le for repair is important. Rectocele with concomitant cystocele is be st repaired transvaginally. An alternative approach is recommended for enterocele. Methods With the patient in the prone position and using local anaesthesia, a mucomuscular endorectal flap is raised and the un derlying tissues are plicated. The excessive flap is excised, and the cut edges are approximated. A retrospective review of 123 consecutive cases of transanal repair of rectocele was conducted. Patient satisfac tion and complications were compared with those in a previously report ed study. Results Overall patient satisfaction improved from 63 per ce nt of 59 patients in an earlier study to 82 per cent in this report. T he overall complication rate decreased from 7 to 3 per cent. Conclusio n This study demonstrates the validity of a simple technique of transa nal repair of rectocele in an ambulatory setting. Minimal morbidity an d successful outcome can be achieved with this procedure.