Transanal repair of rectocele: prospective assessment of functional outcome and quality of life. (12th September 2019)

• Record Type: Journal Article
• Authors: Tsunoda, A.; Takahashi, T.; Kusanagi, H.
• Is Part Of: Colorectal disease. Volume 22:Number 2(2020)
• Page Start: 178
• Page End: 186
• Publication Date: 2019-09-12
• Subjects: Functional results -- quality of life -- rectocele -- transanal repair; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.14833
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: This study aimed to assess the functional outcome of transanal repair of rectocele using patient symptom scores and quality of life (QOL) instruments. Method: Patients who underwent transanal repair for symptomatic rectocele between February 2012 and August 2017 were included. This study was a retrospective analysis of prospectively collected data. A standard questionnaire including the Constipation Scoring System (CSS), the Fecal Incontinence Severity Index (FISI) and QOL instruments [Patient Assessment of Constipation (PAC)‐QOL, Fecal Incontinence QOL Scale, Short‐Form 36 Health Survey (SF‐36)] was administered before and after the operation. Physiological assessment and proctography were performed before and after the operation. Results: Thirty patients were included. The median follow‐up was 36 (6–72) months. Postoperative proctography showed a reduction in rectocele size [34 mm (14–52 mm) vs 10 mm (0–28 mm), P < 0.0001]. Physiological assessment showed no significant postoperative changes. Constipation was improved in 15/21 patients (71%) at 1 year and 14/20 patients (70%) at the mid‐term follow‐up. The CSS score reduced at 3 months [12 (8–12) vs 6 (1–12), P < 0.0001] and remained significantly reduced over time until the mid‐term follow‐up. Faecal incontinence was improved in two‐thirds patients at 1 year. Four patients developed new‐onset faecal incontinence. All the PAC‐QOL scale scores significantly improved over time until 1 year, while two of the eight SF‐36 scale scores showed significant postoperative improvement. Conclusion: Transanal repair for rectocele improves constipation and constipation‐specific QOL.