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Urogynecological Assessment and Perspective in Patients Presenting with Evacuatory Dysfunction

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Complex Anorectal Disorders

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Conclusions

The gynecologic indications for enterocele and rectocele repair are more numerous compared with the traditional colorectal indications because gynecologists primarily address vaginal symptoms when repairing a rectocele. Here, obstructive defecation symptoms are only some of a list of accepted indications. Preoperative evaluation typically only includes clinical assessment gained from the history and physical examination, and gynecologists rarely depend on defecography to plan a reconstructive procedure for rectoceles. Overall, surgical correction success rates are quite high when using a vaginal approach for rectocele correction. Vaginal dissection results in better visualization and access to the endopelvic fascia and levator musculature, which allows for a “firmer” anatomic correction. In addition, maintaining rectal mucosal integrity appears to reduce the risk of postoperative infection and fistula formation. More comprehensive data collection is necessary to better understand the effect of various surgical techniques on vaginal, sexual, and defecatory symptoms in these patients who may present with complex symptomatology where the rectocele and/or enterocele represent the dominant clinical finding.

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Authors and Affiliations

  1. Department of Gynecology, Section of Urogynecology and Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Jennifer T. Pollak MD & G. Willy Davila MD

Authors
  1. Jennifer T. Pollak MD
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  2. G. Willy Davila MD
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© 2005 Springer-Verlag London Limited

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Pollak, J.T., Davila, G.W. (2005). Urogynecological Assessment and Perspective in Patients Presenting with Evacuatory Dysfunction. In: Complex Anorectal Disorders. Springer, London. https://doi.org/10.1007/1-84628-057-5_33

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  • DOI: https://doi.org/10.1007/1-84628-057-5_33

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-690-5

  • Online ISBN: 978-1-84628-057-3

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