Changes in bowel function following transanal and transvaginal rectocele repair.

AIM: This study was designed to compare preoperative and postoperative bowel functions in patients with rectocele repair.

METHODS

Patients who underwent surgery for rectocele between October 1988 and October 2004 were enrolled. Prior to surgery, the patients were asked to complete a questionnaire regarding evacuation difficulty, itching, fecal incontinence, and the need for digitation. Surgery was performed either transanally (group I) or transvaginally (group II). At follow-up after 12 months, the same questionnaire was obtained in the outpatient clinic or by mail to evaluate preoperative and postoperative changes in bowel function.

RESULTS

There were 71 patients in group I and 40 patients in group II. The median age was 56 years in group I and 67 years in group II. The evacuation difficulty was significantly improved in both group I (p < 0.001) and group II (p < 0.001). Incontinence to flatus was slightly increased in group I (p = 0.33) and group II (p = 0.6). Incontinence to solid stool was not statistically different in either group. The need for digitation was markedly improved in group I (p < 0.001) and group II (p = 0.0017).

CONCLUSION

Although surgery for rectocele potentially increases the risk of fecal incontinence, it may be indicated if presented with evacuation difficulty necessitating digitation.