Abdominal rectovaginopexy: modified technique to treat XXXX .

@entity1 @entity1241 @entity1142
PURPOSE: We noted the combination of obstructed defecation or @entity1142 and @entity1241 , the poor results of abdominal rectopexy for @entity1142 , and the well-known risk of postoperative induction of @entity1142 after rectopexy. We developed a new operation to treat @entity1 with @entity1142 or @entity1241 (with a concomitant rectocele, internal rectal intussusception, enterocele at dynamic defecography, or all three) or both. This new rectopexy technique avoided dorsolateral mobilization of the rectum and did not endanger the hypogastric nerves and pelvic autonomic nerves. A better effect on @entity1142 compared with rectopexies with dorsolateral mobilization was expected. METHODS: The results of this new operation, which was called rectovaginopexy, were studied prospectively in a series of 27 @entity1 . Four-year results were obtained. Preoperative and postoperative questionnaires, dynamic defecograms, and anorectal physiology studies were analyzed. RESULTS: Before the operation 17 @entity1 were constipated, compared with 4 @entity1 one year after rectovaginopexy (76 percent improvement; P = 0.0015) and 5 @entity1 four years after rectovaginopexy (71 percent improvement: P = 0.005), respectively. At one year, @entity1241 decreased significantly: 15 of 17 @entity1 improved and 9 @entity1 became fully continent (P = 0.0007). Four years after rectovaginopexy the effect on @entity1241 was no longer significant (P = 0.09). Rectovaginopexy restored anatomy: all (9) enteroceles, all but 1 (17) internal rectal intussusception, and 12 of 20 rectoceles dissolved, and the majority were reduced in size. Rectal sensation for distention was unchanged, and rectal electrosensitivity improved (P = 0.04). CONCLUSIONS: Rectovaginopexy provides significant one-year improvement of both @entity1142 and @entity1241 . The positive effect on @entity1142 did not deteriorate with time, in contrast to the effect on @entity1241 .
