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Preoperative predictors of success after transvaginal rectocoele repair

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Abstract

Purpose

Determine predictors of success for transvaginal rectocoele repair (TVRR). Primary aim is to establish predictors of successful treatment analysing patients’ characteristics, baseline symptoms, pelvic floor test results and pre-operative conservative treatment.

Methods

Retrospective single institution study in a tertiary referral centre for pelvic floor disorders. 207 patients underwent TVRR for symptomatic rectocoele. Information about symptoms related to obstructive defaecation, anal incontinence and vaginal prolapse, results of pelvic floor investigations, multimodality conservative management and variation in surgical technique have been recorded. Symptom related information have been collected at surgical follow-up.

Results

115 patients had residual symptoms after surgical repair of rectocoele, while 97 were symptoms free. Factors associated with residual symptoms after surgical repair are previous proctological procedures, urge AI symptoms, absence of vaginal bulge symptoms, use of transanal irrigation and having a concomitant enterocoele repair during procedure.

Conclusion

Factors able to predict a less favourable outcome after TVRR in patients with concomitant ODS are previous proctological procedures, presence of urge AI, short anal canal length on anorectal physiology, seepage on defaecating proctography, use of transanal irrigation, absence of vaginal bulge symptoms and enterocoele repair during surgery. These information are important for a tailored decision making process and to manage patients’ expectations before surgical repair.

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Data Availability

Data are available upon request.

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Acknowledgements

We acknowledge the pelvic floor nurses, women’s health physiotherapists and clinical scientists working in our pelvic floor unit for their dedication and activity.

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Authors and Affiliations

  1. Pelvic Floor Unit, Mitchener Ward, St Thomas’ Hospital, Guy’s and St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE17EH, UK

    Linda Ferrari, Karina Cuinas, Alison Hainsworth, Amir Darakhshan, Alexis Schizas, Cornelius Kelleher & Andrew Brian Williams

Authors
  1. Linda Ferrari
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  2. Karina Cuinas
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  3. Alison Hainsworth
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  4. Amir Darakhshan
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  5. Alexis Schizas
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  6. Cornelius Kelleher
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  7. Andrew Brian Williams
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Corresponding author

Correspondence to Linda Ferrari.

Ethics declarations

Ethical approval

18/SC/0147.

Trial registration

Not applicable, ethical approval was requested to retrospectively collect data and review information about patients underwent TVRR, but no prospective trial was designed.

Financial disclosure

None.

Funding

None.

Conflict of interest

There are no conflict of interest to declare.

Authorship and contribution

LF designed the study, collected the data and drafted the manuscript. KC conducted statistical analysis and organised data. AH was responsible of correction and critical revision and of the manuscript. Mr AS, Mr AD and Mr CK participated in data interpretation. Mr AW conducted critical revision of the manuscript.

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Ferrari, L., Cuinas, K., Hainsworth, A. et al. Preoperative predictors of success after transvaginal rectocoele repair. Tech Coloproctol 27, 859–866 (2023). https://doi.org/10.1007/s10151-023-02822-1

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  • DOI: https://doi.org/10.1007/s10151-023-02822-1

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