Good Post-operative Results Depend on Strict Patient Selection and Strict Operative Procedure

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J Korean Soc Coloproctol. 2012;28(3):118-118
Publication date (electronic) : 2012 June 30
doi : https://doi.org/10.3393/jksc.2012.28.3.118
Department of Surgery, Sahmyook Medical Center, Seoul, Korea.
Correspondence to: Yong Hee Hwang, M.D. Department of Sugery, Sahmyook Medical Center, 82 Mangu-ro, Dongdaemun-gu, Seoul 130-711, Korea. Tel: +82-2-2210-3563, Fax: +82-2-2212-2673, hwangyon@hotmail.com

See Article on Page 140-144

Post-operative results are variable. Some rectoceles might be caused by a paradoxical puborectalis contraction leading to an outlet obstruction and to disappointing surgical results [1]. Thus, an anorectal physiologic study including anal sponge (anal plug) electromyography should be performed for excluding non-relaxing puborectalis syndrome [2]. In that case, biofeedback therapy should be applied first. A vital point for a good post-operative result is the tightness (strength) of the reconstructed rectovaginal septum even though long-term post-operative results aredisappointing [3]. A larger decrease in the rectocele diameter means greater strength of the rectovaginal septum.

References

1. Johansson C, Nilsson BY, Holmström B, Dolk A, Mellgren A. Association between rectocele and paradoxical sphincter response. Dis Colon Rectum 1992;35:503–509. 1568403.
2. Rosato GO, Lumi CM, Miguel AM. Anal sphincter electromyography and pudendal nerve terminal motor latency assessment. Semin Colon Rectal Surg 1992;3:68–74.
3. van Dam JH, Hop WC, Schouten WR. Analysis of patients with poor outcome of rectocele repair. Dis Colon Rectum 2000;43:1556–1560. 11089592.

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