Selection criteria for anterior rectal wall repair in symptomatic rectocele and anterior rectal wall prolapse

Abstract

PURPOSE: This study was undertaken to determine the outcome and changes produced by an endorectal anterior wall repair in objective functional parameters using anorectal manometry and defecography and to asses their usefulness in the selection of patients for the operation. METHODS: Between 1986 and 1990, we performed a prospective study of 76 consecutive patients with symptomatic rectocele and/or an anterior rectal wall prolapse. All patients were studied prospectively according to a fixed protocol. Standard questionnaire, defecation diary, clinical examination, defecography, and anal manometry were performed preoperatively and three to four months postoperatively. RESULTS: Three months postoperatively, 38 patients (50 percent) had no complaints at all (excellent result), 32 (42 percent) had only a minor complaint (good result), and in 6 patients (8 percent) the complaints were essentially unchanged (unsatisfactory result). After one year, similar figures were obtained. The postoperative mean stool frequency in all patients after three months was significantly increased (P .