We have located links that may give you full text access.
Comparative Study
Journal Article
Abdominal sacrocolpopexy and anatomy and function of the posterior compartment.
Obstetrics and Gynecology 2001 May
OBJECTIVE: To assess the effect of abdominal sacrocolpopexy with obliteration of the pouch of Douglas on anatomy and function of the posterior compartment.
METHODS: We prospectively studied 33 consecutive women with pelvic organ prolapse who had abdominal sacrocolpopexies [expanded polytetrafluoroethylene (Gore-Tex)] with pouch of Douglas obliterations and posterior extensions of mesh, using a standardized questionnaire, urodynamic studies, pelvic floor fluoroscopies, and vaginal-rectal examinations (Baden-Walker classification). Concomitant colpoperineorrhaphy was done if rectoceles remained at rectovaginal examination at the end of sacrocolpopexy. The goal was to correct rectoceles transabdominally.
RESULTS: Thirty-one women returned for follow-up investigations after 12--48 months (mean 26 months). Mean age was 61 years (range 41--77 years). There was no recurrence of vaginal vault prolapse, enterocele, or anterior rectal wall prolapse. Among 28 preoperative rectoceles, 16 recurred (57%) and one occurred de novo. Defecation problems (outlet constipation) were present in 21 women (64%) preoperatively and persisted or were altered in 12 (57%) after sacrocolpopexy. Grade of rectocele was associated significantly with symptoms of outlet constipation preoperatively, but not postoperatively (P =.002).
CONCLUSION: Abdominal sacrocolpopexy with obliteration of the pouch of Douglas and posterior extension of the mesh was effective for vaginal vault prolapse, enterocele, and anterior rectal wall procidentia, but not concomitant rectocele. Twenty-eight percent of women described altered defecation with stool stopping higher in the rectosigmoid colon ("high outlet constipation"), which might have been caused by denervation during rectal mobilization.
METHODS: We prospectively studied 33 consecutive women with pelvic organ prolapse who had abdominal sacrocolpopexies [expanded polytetrafluoroethylene (Gore-Tex)] with pouch of Douglas obliterations and posterior extensions of mesh, using a standardized questionnaire, urodynamic studies, pelvic floor fluoroscopies, and vaginal-rectal examinations (Baden-Walker classification). Concomitant colpoperineorrhaphy was done if rectoceles remained at rectovaginal examination at the end of sacrocolpopexy. The goal was to correct rectoceles transabdominally.
RESULTS: Thirty-one women returned for follow-up investigations after 12--48 months (mean 26 months). Mean age was 61 years (range 41--77 years). There was no recurrence of vaginal vault prolapse, enterocele, or anterior rectal wall prolapse. Among 28 preoperative rectoceles, 16 recurred (57%) and one occurred de novo. Defecation problems (outlet constipation) were present in 21 women (64%) preoperatively and persisted or were altered in 12 (57%) after sacrocolpopexy. Grade of rectocele was associated significantly with symptoms of outlet constipation preoperatively, but not postoperatively (P =.002).
CONCLUSION: Abdominal sacrocolpopexy with obliteration of the pouch of Douglas and posterior extension of the mesh was effective for vaginal vault prolapse, enterocele, and anterior rectal wall procidentia, but not concomitant rectocele. Twenty-eight percent of women described altered defecation with stool stopping higher in the rectosigmoid colon ("high outlet constipation"), which might have been caused by denervation during rectal mobilization.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app