A prospective comparison between clinical outcome and open-configuration magnetic resonance defecography findings before and after surgery for symptomatic rectocele.

Details

Serval ID
serval:BIB_68FDB4F6F3BF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A prospective comparison between clinical outcome and open-configuration magnetic resonance defecography findings before and after surgery for symptomatic rectocele.
Journal
Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Author(s)
Hübner M., Hetzer F., Weishaupt D., Hahnloser D., Clavien P.A., Demartines N.
ISSN
1462-8910 (Print)
ISSN-L
1462-8910
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
8
Number
7
Pages
605-611
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: The correlation between clinical symptoms and anatomical findings by conventional imaging is poor in patients with rectoceles. The aim of this prospective study was to assess and to correlate symptomatic changes after anterior levatorplasty with morphologic changes visualized by magnetic resonance defecography (MRD).
METHOD: Fourteen women with a median age of 57 (range 37-83) accepted to participate. Seven of 14 had previous hysterectomy. Patients underwent MRD before surgery and again 6 months postsurgery. Pre- and postoperative symptoms and quality of life (QoL) (Eypasch) were assessed. Faecal and urinary incontinence were graded (Wexner- / Hanley-score).
RESULTS: The median Eypasch-score improved from 90 (range 38-106) to 106 (range 29-133) after surgery (P = 0.016). Similarly, the Wexner-score ameliorated from 8 (range 0-20) to 4.5 (range 0-18; P = 0.02). Seven patients described new dyspareunia postoperatively. The median follow up was 16.5 months (range 9-45). The median rectocele size decreased from 37 mm (range 30-48) preoperatively to 12 mm (range 0-42) postoperatively (P = 0.004). Furthermore, enteroceles were corrected and pelvic floor descent was significantly reduced after surgery. Only the clinical symptom of incomplete evacuation strongly correlated with the respective radiological finding of contrast dye trapping (Rho = 0.822; P = 0.001).
CONCLUSION: Anterior levatorplasty improved QoL in patients with symptomatic rectocele. Postsurgical correction of rectocele is accurately documented by MRD. Only moderate correlation between morphologic and clinical improvements was observed.
Keywords
Adult, Aged, Aged, 80 and over, Anal Canal/physiopathology, Anal Canal/radiography, Defecography, Digestive System Surgical Procedures/methods, Electromyography, Female, Humans, Middle Aged, Postoperative Complications/physiopathology, Postoperative Complications/radiography, Preoperative Care/methods, Prospective Studies, Quality of Life, Rectocele/physiopathology, Rectocele/radiography
Pubmed
Web of science
Create date
28/01/2008 9:53
Last modification date
20/08/2019 15:24
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