NOVEL-APPROACH TO COMBINED DEFECATION AND MICTURITION DISORDERS WITH RECTOVAGINOVESICOPEXY

Background This study was conducted to investigate the results of rect ovaginovesicopexy (RVVP) in patients with combined defaecation and mic turition disorders. RVVP was developed from a standard procedure for d ifferent forms of defaecation disorders (the rectovaginopexy (RVP)). I t is only a limited extension to the RVP and results in elevation of a ll three pelvic compartments. Methods In a consecutive series of 25 pa tients the effects or RVVP were evaluated prospectively. Information a bout the clinical history and results was obtained by a standard quest ionnaire filled out before and 3 and 12 months after operation. Dynami c defaecography was performed before and 3 months after RVVP. Before o peration urodynamic studies were conducted. Results RVVP improved cons tipation (14 of 18 patients improved, P = 0.001), faecal incontinence (11 of 16 patients improved, P = 0.005) and dysfunctional voiding (ten of 16 patients improved, P = 0.07) without induction of these disorde rs. Overall urinary incontinence improved in 11 of 22 patients (P = 0 18), with deterioration of urinary incontinence in three and induction of urinary incontinence in two of the patients. Patients with isolate d urinary stress incontinence fared better (eight of 13 patients impro ved) than those with mixed urinary incontinence. Conclusion RVVP provi des satisfactory improvement of combined defaecation and micturition d isorders. The benefits of a limited extension of the RVP seem to outwe igh potential side-effects such as deterioration or de novo defaecatio n or micturition disorders.