Postnatal Results of Colporraphy Posterior

Year 2023, Volume: 12 Issue: 3, 194 - 199, 29.12.2023

Alev Esercan , İsmail Demir

https://doi.org/10.47493/abantmedj.1304960

Abstract

Objective: Although most of the rectoceles are asymptomatic, they occur as a result of multiple births, giving birth to large babies, and situations that increase or disrupt intra-abdominal pressure. Posterior colporrhaphy surgery can be performed as a surgical option in the treatment of symptomatic rectocele. In the literature, it is not clear whether patients can become pregnant after this surgery, and whether the rectocele will recur if vaginal delivery is performed, and there are very few patients.
Materials and Methods: It was aimed to investigate the results of the follow-ups of patients with symptomatic rectocele in Şanlıurfa Training and Research Hospital between 2016-2023 and the results of those who gave birth.
Results: In the results of 546 patients with stage 2 and 3 rectoceles after posterior colporrhaphy surgery without mesh. The mean age of the patients was 41.51±11.74 years and the mean parity was 5.06±1.66 births. 115 of 546 patients became pregnant after surgery and 92 of them gave vaginal delivery. The mean birth weight of the babies was 3280±258 grams. The mean follow-up period after surgery was 11.48±9.34 (1-60) months, and no recurrence of rectocele was observed in both those who gave birth and those who did not give birth.
Conclusion: Although there is no other study with such a large number of patients in the literature, it seems that patients who want to have posterior colporrhaphy surgery do not need to delay having a child.

Keywords

pelvic organ prolapse, rectocele, colporraphy posterior

Arka Kolporafi Ameliyatı Olup Doğum Sonrası Sonuçları

Abstract

Amaç: Rektoselin çoğu asemptomatik olmakla birlikte; fazla sayıda doğum, iri bebek doğurma, karın içi basıncını artıran ve bozan durumlar sonucunda oluşur. Semptomatik rektoselin tedavisinde bir cerrahi seçenek olarak arka kolporafi ameliyatı yapılabilmektedir. Literatürde bu ameliyat sonrası hastaların gebe kalıp kalamayacağı, vajinal doğum yapılırsa rektoselin nüks edip etmeyeceği net değildir ve çok az sayıda hasta vardır.
Gereç ve Yöntemler: Şanlıurfa Eğitim Araştırma Hastanesi’nde 2016-2023 yılları arasında semptomatik rektosel nedeniyle arka kolporafi ameliyatı olup ameliyat sonrası dönemde doğum yapanların sonuçlarını araştırmak hedeflenmiştir.
Bulgular: Evre 2 ve 3 rektoseli olan 546 hastaya mesh kullanılmadan arka kolporafi ameliyatı yapılmıştır. Çalışmaya alınan hastaların ortalama yaşı 41,51±11,74 yıl ve paritesi 5,06±1,66 doğumdu. 546 hastanın 115’si ameliyat sonrası gebe kalarak bunların 92’si vajinal doğum yapmıştır. Bebeklerin ortalama doğum kilosu 3280±258 gramdı. Ameliyattan sonra ortalama takip süresi 11,48±9,34 (1-60) ay olup takiplerde hem doğum yapanlar hem de doğum yapmayanların hiçbirinde rektosel nüksü görülmemiştir.
Sonuç: Literatürde bu kadar fazla hasta sayısına sahip başka çalışma bulunmamakla birlikte sonuç olarak arka kolporafi ameliyatı olmak isteyen hastaların çocuk sahibi olmayı ertelemelerine gerek yok gibi gözükmektedir.

Keywords

Arka kolporafi, pelvik organ prolapsusu, rektosel

Supporting Institution

YOK

References

• Maeda K, Maruta M, Hanai T, et al. Transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele. Tech Coloproctol 2003;7:181-5.
• Kim JH, Kim DH, Lee YP. Long-term comparison of physiologic anorectal changes and recurrence between transanal repair and transanal repair with posterior colporrhaphy in rectocele. Asian J Surg 2020;43:265-71.
• Balata M, Elgendy H, Emile SH, Youssef M, Omar W, Khafagy W. Functional Outcome and Sexual-Related Quality of Life After Transperineal Versus Transvaginal Repair of Anterior Rectocele: A Randomized Clinical Trial. Dis Colon Rectum 2020;63:527-37.
• Tsunoda A, Takahashi T, Kusanagi H. Transanal repair of rectocele: prospective assessment of functional outcome and quality of life. Colorectal Dis 2020;22:178-86.
• Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 1996;175:10-7.
• Palit S, Bhan C, Lunniss PJ, et al. Evacuation proctography: a reappraisal of normal variability. Colorectal Dis 2014;16:538-46.
• de Leeuw JW, Struijk PC, Vierhout ME, Wallenburg HC. Risk factors for third degree perineal ruptures during delivery. BJOG 2001;108:383-7.
• Okamoto N, Maeda K, Kato R, Senga S, Sato H, Hosono R. Dynamic pelvic three-dimensional computed tomography for investigation of pelvic abnormalities in patients with rectocele and rectal prolapse. J Gastroenterol 2006;41:802-6.
• Murthy VK, Orkin BA, Smith LE, Glassman LM. Excellent outcome using selective criteria for rectocele repair. Dis Colon Rectum 1996;39:374-8.
• Harris MA, Ferrara A, Gallagher J, DeJesus S, Williamson P, Larach S. Stapled transanal rectal resection vs. transvaginal rectocele repair for treatment of obstructive defecation syndrome. Dis Colon Rectum 2009;52:592-7.
• Rahmanou P, White B, Price N, Jackson S. Laparoscopic hysteropexy: 1- to 4-year follow-up of women postoperatively. Int Urogynecol J 2014;25:131-8.
• Szymanowski P, Szepieniec WK, Stuwczynski K, Gruszecki P. Cesarean section after laparoscopic hysterosacropexy with Richardson's lateral repair and Burch operation-Case report. Int J Surg Case Rep 2019;59:185-9.