[Repair of rectovaginal septum with pedicled fascia flap].

OBJECTIVE

To observe the clinical effect of repairing rectovaginal septum with graft of fascia flap with blood vessels.

METHODS

From August 2004 to August 2006, 12 female patients with rectocele were treated, aging 49-73 years. The disease course was from 5 to 30 years(mean, 5.6 years). All patients suffered dysporia. X-ray films showed severe rectocele (> or = 30 mm), or with the descendent perineum syndrome (> or = 40 mm), and inner pendant rectal mucosa (3 cases) and/or narrow anal canal (9 cases). The size of fascia flap ranged from 15 cm x 3 cm to 18 cm x 5 cm.

RESULTS

The bleeding amount was 800 ml in 2 cases, and 500 ml in 10 cases. All fascia flaps survived. In the 12 patients, 11 had a primary wound healing (Stage I), 1 had a delayed wound healing (Stage II). The donor sites healed at Stage II. Twelve patients could defecate normally 4-6 days after surgery. The legs edema occurred in 2 cases, urinary retention combined with infection occurred in 1 case. And all recovered completely after treatment. Eleven patients were followed up for 6 to 12 months. Digital anorectal examination showed prerectal pouch disappearance, glaze surface and good elasticity. X-ray films and CT showed that the rectocele disappeared.

CONCLUSION

The operation of repairing rectovaginal septum with graft of fascia with blood vessels can effectively recover anatomy of rectovaginal septum and its normal biological function.