A prospective study of the discrete fascial defect rectocele repair

Background The aim of this study is to describe the results of the discrete fascial defect rectocele repair with special emphasis on dyspareunia after the operation. Methods. Sixty-seven women underwent rectocele repair from October 1997 to January 1999. Repair was limited to reapproximation of discrete defects in the rectovaginal fascia when possible and a small perineorrhaphy. Each patient was evaluated as to whether or not a discrete defect was present and the location of the fascial defect. Outcome measures were complications, recurrent prolapse after 3 months, changes in defecation problems and dyspareunia after the operation. Results. In 96% (64/67) of the patients a discrete defect was present. Before the operation 40% (27/67) reported problems with evacuation of the rectum and 12% (8/67) dyspareunia or problems with intercourse because of the prolapse. The patients were evaluated 3 months after the operation. Only three patients still complained of evacuation problems and only two patients with prior dyspareunia still had problems, which were cured after a further 3 months. Two patients had de novo dyspareunia but in only one patient was an anatomical defect found. Conclusions. The discrete defect rectocele repair offers an anatomical correction of the rectocele, which alleviates the symptoms but, most important, does not give the woman dyspareunia. Long term results of the operation are awaited.