Kościński Tomasz, Szubert Sebastian, Sajdak Stefan
Department of General, Endocrine and Gastroenterological Oncology Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Ann Agric Environ Med. 2016 Dec;23(4):692-695. doi: 10.5604/12321966.1226868.
A rectocele is a hernation of the rectum into the vaginal lumen developing as a consequence of weakness of the rectovaginal septum. It affects about 18% of women after childbearing age. Symptoms associated with a rectocele include constipation, vaginal fullness or heaviness, feeling of a bulging mass within vagina, incomplete stool evacuation and dyspareunia. Current methods of surgical treatment of a rectocele often require implantation of a mesh graft. In most of cases, synthetic and non-absorbable meshes are used. Although implantation of a synthetic and non-absorbable mesh is effective in the treatment of rectocele, a high rate of mesh erosion has been reported.
This study presents a surgical technique and case report for the treatment of a rectocele in a 46-year-old women by implantation of a porcine-derived absorbable collagen mesh (Pelvicol®) by transvaginal approach, with six year follow-up. A review of the literature concerning implantation of Pelvicol® for the treatment of rectocele was also undertaken.
The clinical experience and review of the literature by the authors suggest that a porcine-derived acellular mesh is non-cytotoxic, pyrogenic or allergenic, and the application of a biomesh in the management of rectocele is effective and safe, and the risk of mesh erosion is very low.
直肠膨出是指直肠向阴道腔内突出，是直肠阴道隔薄弱的结果。它影响约18%的育龄后女性。与直肠膨出相关的症状包括便秘、阴道胀满或沉重感、阴道内有肿物突出感、排便不尽和性交困难。目前直肠膨出的手术治疗方法通常需要植入网状移植物。在大多数情况下，使用合成的不可吸收网片。虽然植入合成的不可吸收网片对直肠膨出的治疗有效，但据报道网片侵蚀率很高。
本研究介绍了一种通过经阴道途径植入猪源可吸收胶原网片（Pelvicol®）治疗一名46岁女性直肠膨出的手术技术及病例报告，并进行了六年随访。还对有关植入Pelvicol®治疗直肠膨出的文献进行了综述。
作者的临床经验和文献综述表明，猪源脱细胞网片无细胞毒性、无热原性或过敏性，生物网片在直肠膨出治疗中的应用有效且安全，网片侵蚀风险非常低。
