The put-pose of the study was to determine the durability of success after
rectocele repair and to evaluate parameters that might influence long-term
results. Twenty-five patients with rectocele were prospectively evaluated b
oth clinically and physiologically. Follow-up was performed twice, at 1 and
5.1 years postoperatively. Twenty-four patients had a long-term follow-up;
21/23 patients (91%) with preoperative symptoms of rectal emptying difficu
lty reported improvement of their symptoms and 9 of 12 (75%) with preoperat
ive symptoms of pelvic heaviness reported relief at long-term follow-up. Al
l 5 patients with preoperative pathologic transit study had various degrees
of rectal emptying difficulty at long-term follow-up. Three of 5 patients
with preoperative paradoxical sphincter reaction (PSR) at electromyography
(EMG) reported improvement of the symptoms of rectal emptying difficulty at
long-term follow-up. Surgery for rectocele is associated with improved sym
ptoms in a majority of patients which are sustained long term. Patients wit
h pathologic transit study may have a less favorable symptomatic outcome. T
he clinical significance of PSR needs further study.