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功能障碍:直肠膨出。

Functional disorders: rectocele.

作者信息

Lefevre Roger, Davila G Willy

机构信息

Department of Gynecology, Cleveland Clinic Florida, Weston, FL 33331, USA.

出版信息

Clin Colon Rectal Surg. 2008 May;21(2):129-37. doi: 10.1055/s-2008-1075862.

Abstract

The baseline prevalence of rectocele is not well defined as many women are asymptomatic and do not seek medical help. Gynecologists tend to perform posterior wall repairs more commonly than colorectal surgeons because they also address patients with vaginal symptoms in addition to those with defecatory dysfunction. Overall, surgical correction success rates for rectocele correction are quite high when using a vaginal approach. Vaginal dissection, as opposed to transrectal or transperineal approaches, results in better visualization and access to the endopelvic fascia and levator musculature, allowing for more firm anatomic correction. In addition, the maintenance of rectal mucosal integrity may reduce the risk of postoperative complications such as infection and fistula formation. With the rapidly growing popularity of synthetic and biologic implant kits in the field of pelvic reconstruction, outcomes data reporting is increasing and allowing surgeons to better understand the effect of various surgical techniques on vaginal, sexual, and defecatory symptoms.

摘要

直肠膨出的基线患病率尚未明确界定,因为许多女性没有症状,也不寻求医疗帮助。妇科医生比结直肠外科医生更倾向于进行后壁修复,因为除了有排便功能障碍的患者外,他们还会诊治有阴道症状的患者。总体而言,采用阴道入路进行直肠膨出矫正的手术成功率相当高。与经直肠或经会阴入路不同,阴道解剖能更好地观察和触及盆腔内筋膜和提肌组织,从而实现更稳固的解剖学矫正。此外,保持直肠黏膜完整性可降低术后感染和瘘管形成等并发症的风险。随着合成和生物植入套件在盆腔重建领域的迅速普及,关于手术结果的数据报告越来越多,这使外科医生能够更好地了解各种手术技术对阴道、性功能和排便症状的影响。

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