DIAGNOSIS AND TREATMENT ASPECTS OF RECTOCELE

Abstract

In the Department of Proctology of TSMU First University Clinic a clinical trial was carried out on 58 patients suffering from anterior rectocele. The goal of the research was to increase the efficacy of the rectocele treatment. The algorithm of the working plan was determined: to collect detailed anamnesis, carry out digital as well as bidigital rectal and vaginal examination, anoscopy, sigmoidoscopy, X-ray contrast evacuation proctography (dynamic rectal examination (DRE)), transrectal ultrasound scan (TRUS) and to use balloon expulsion test to identify the location, the size and the degree of prolapse.Significant improvement was achieved with conservative therapy in 31 patients (53.7%) who had first degree of the impaired evacuation functions and the pelvic floor muscle dysfunctions. The therapy included specific diet, medications, medical fitness, and in some cases, percutaneous tibial nerve stimulation (PTNS) and biofeedback therapy.Surgical intervention appeared to be necessary in 27 patients with II and III degrees of impairment, where a transvaginal and transperineal approach was used. Rectocele repair surgery, levatorplasty, restoration of the rectovaginal septum and the posterior vaginal wall was carried out. After surgical operations successful outcome was achieved in 92.6% (25 patients).