Pelvic posterior compartment defects: comparative study of two vaginal surgical procedures

Abstract

This study was undertaken to compare two surgical techniques for rectocele repair. Between January 2005 and December 2010, 180 patients with III grade symptomatic rectocele were enrolled in this alternative prospective randomized study. 90 patients (group A) were treated with perineal body anchorage of posterior septum, and 90 (group B) with the traditional Denonvilliers’ transversal suture. Pre- and post-operative data, including Ap and Bp values, recurrence rates and quality of life was assessed. The mean follow-up was 22 months (range 9-72 months). For statistical purpose, Student’s t test, chi-square test and logistic regression analysis were evaluated. Post-operatively, in group A Ap and Bp value were respectively –2.0±1.0 and –2.5±0.5 (P<0.001 for both values). In group B, Ap and Bp value were respectively –1.9±2.1 and –2.1±0.9 (P<0.001 for both values). A total of 81 (93.1%) patients in group A and 76 (86.3%) in group B reported improvement in symptoms (P=0.222) after surgery. Recurrence rates were 5 (5.7%) and 6 (6.8%) respectively (P=0.984). Quality of life improved significantly in both groups. In conclusion, both techniques are effective for the posterior compartment repair.

Keywords

• rectocele
• posterior compartment
• prolapse.