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Techniques in Coloproctology

, Volume 22, Issue 4, pp 289–294 | Cite as

Pelvic floor function following ventral rectopexy versus STARR in the treatment of obstructed defecation

  • D. F. Altomare
  • A. Picciariello
  • R. Memeo
  • M. Fanelli
  • R. Digennaro
  • N. Chetta
  • M. De Fazio
Original Article

Abstract

Background

Obstructed defecation syndrome (ODS), most commonly found in females, can be treated by a transanal or abdominal approach with good success rate. Nevertheless, patients may experience de novo or persisting pelvic floor dysfunctions after surgery. The aim of this study was to compare the functional outcome of stapled transanal rectal resection (STARR) and ventral rectopexy (VRP) in a series of ODS patients.

Methods

Forty-nine female patients who had surgery for ODS between 2006 and 2016 were retrospectively evaluated: 28 (median age 60 years, IQR 54–69 years) had VRP and 21 (median age 58 years, IQR 51–66 years) had STARR. ODS was scored with the ODS score while the overall pelvic floor function was assessed with the three axial perineal evaluation (TAPE) score. Quality-of-life was evaluated by the patient assessment of constipation quality-of-life (PAC-Qol) questionnaire administered preoperatively and after 1 year of follow-up.

Results

The preoperative median ODS score and TAPE score were comparable in both groups. After a median follow-up of 12 months (range 12–18 months), the median ODS score was 12 (range 10–20) in the STARR group and 9 (range 3–15) in the VRP one (p = 0.02), while the median TAPE score was 70.5 (IQR 60.6–77.3) in the former and 76.8 (IQR 70.2–89.7) in the latter (p = 0.01). Postoperatively the physical domain of the PAC-QoL score had a median value of 2.74 (IQR 1.7–3.75) in the STARR group compared to 1.5 (IQR 1–2.5) in the VRP group (p = 0.03). No major complications were recorded in either group.

Conclusions

VRP and STARR can improve defecation in patients with ODS with minimal complications, but the overall pelvic wellness evaluated by the TAPE score improves significantly only after VRP, suggesting a better performance of VRP than STARR when overall pelvic floor function is concerned.

Keywords

Defecation Constipation STARR Surgical stapling Digestive system surgical procedures Pelvic floor Quality of life 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the independent Ethics Committee of the Azienda Ospedaliero-Universitazla Policlinico BARI.

Informed consent

All patients received and agreed to the patient information sheet and informed consent for the study and procedure.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Emergency and Organ Transplantation and Inter-Department Research Center for Pelvic Floor Disease (CIRPAP)University Aldo Moro of BariBariItaly
  2. 2.Nuclear Medicine UnitD.I.M. University Aldo Moro of BariBariItaly

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