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Eur J Obstet Gynecol Reprod Biol 2020 Jun 17;252:174-180. Epub 2020 Jun 17.

Department of Obstetrics and Gynaecology, University of Abant İzzet Baysal, Bolu, Turkey.

Objective: To interpret the long-term outcomes of transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in patients with stage 3-4 uterovaginal prolapse.

Study Design: This retrospective case-control study from 2007 to 2016 analysed patients' medical records and evaluated gynaecological examinations over 11 years of follow-up. One hundred and forty-three patients who underwent transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy were evaluated. Read More

Colorectal Dis 2020 Jun 27. Epub 2020 Jun 27.

Department of Surgery and Colorectal Surgery, Academic Hospital Maastricht, Maastricht University Medical Center, PO box 5800, 6202 AZ, Maastricht, The Netherlands.

There is an ongoing debate as to whether or not the efficacy of Sacral Neuromodulation (SNM) is optimized by maximizing the total number of active electrode poles (AEPs) during lead placement because there are more programming options. However, this is at the cost of increased operating time. The aims of this study were to establish if a higher number of AEP's improves SNM efficacy during the trial period and after permanent implantable pulse generator (IPG) placement and if was there a correlation between number of AEPs and battery life of the first placed IPG. Read More

Colorectal Dis 2020 Jun 24. Epub 2020 Jun 24.

İzmir Katip Çelebi University Atatürk Training and Research Hospital, Department of General Surgery, İzmir, Turkey.

Laparoscopic procedures for the treatment of rectal prolapse (RP) have gained increasing worldwide acceptance with their lower recurrence rates and better functional outcomes than perineal procedures. Nevertheless, the ideal surgical technique is still controversial. Laparoscopic ventral rectopexy is a successful nerve-sparing technique for the treatment of RP. Read More

Turk J Surg 2019 Jun 13;35(2):91-97. Epub 2019 Jun 13.

Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye.

Objectives: Laparoscopic ventral mesh rectopexy (LVMR) is a technique gaining more recognition for the management of pelvic floor disorders, such as external rectal prolapse (ERP), high grade internal rectal prolapse (IRP) and rectocele. LVMR also allows correction of coexisted pelvic organ prolapse. This study aimed to evaluate the safety, efficacy and functional outcome of LVMR for rectal and complex pelvic organ prolapse. Read More

Urology 2020 Jun 5. Epub 2020 Jun 5.

Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address:

Objective: To present a case series and literature review on post radical cystectomy (RC) pelvic organ prolapse (POP) to heighten awareness of the symptoms, imaging findings, and risk factors associated with this complication and discuss opportunities for prevention. Women with muscle invasive bladder cancer undergo RC with anterior exenteration, significantly disrupting the pelvic floor. These women are at risk for POP. Read More

Turk J Med Sci 2020 Jun 3. Epub 2020 Jun 3.

Background/aim: To investigate the risk of de novo stress urinary incontinence (SUI) occurrence in women who were treated for pelvic organ prolapse (POP) with sacrospinous ligament fixation (SSLF) in addition to vaginal hysterectomy (VAH) and antero-posterior colporrhaphy (CAP) over a 24 month follow up period.

Materials And Methods: A prospective randomized study was designed. Women without occult or obvious SUI were randomized into either one of the study groups: Group1: VAH+CAP, and Group2: VAH+CAP+SSLF. Read More

Harefuah 2020 May;159(5):352-354

Laniado Hospital, Natanya, Israel.

Introduction: Sacrocolpopexy (SCP) is one of the most successful operations for correcting utero-vaginal prolapse and achieving a functional vaginal reconstruction. The operation, which classically calls for an open abdominal approach, can be performed laparoscopically, but it is time-consuming and requires experienced laparoscopists. A few years ago, we introduced a dual vaginal-laparoscopic technique, in which we combined the ease of vaginal suturing with the advantages of laparoscopic SCP. Read More

J Invest Surg 2020 May 18:1-6. Epub 2020 May 18.

Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran.

Obstructive defecation syndrome (ODS) affects quality of life of patients to a great extent by disturbing defecation. Laparoscopic ventral mesh rectopexy (LVMR) has gained much attention in the recent years. Common synthetic used meshes have a risk of erosion for adjacent pelvic organs leading to some complications. Read More

Ann Surg Treat Res 2020 May 28;98(5):277-282. Epub 2020 Apr 28.

Day/Week Surgery Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Purpose: Treatment of rectocele associated with prolapsed hemorrhoids is a debated topic. Transanal stapling achieved good midterm results in patients with symptoms of obstructed defecation, nevertheless a number of severe complications have been reported. The aim of this study was to evaluate the safety and efficacy of a new endorectal manual technique in patients with obstructed defecation due to the combination of muco-hemorrhoidal prolapse and rectocele. Read More

Colorectal Dis 2020 May 12. Epub 2020 May 12.

Department of Surgery, Division of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Abdom Radiol (NY) 2020 Apr 30. Epub 2020 Apr 30.

Department of Internal Medicine, Pratumthani Hospital, 7 Ladlumkaew Muang District, Pratumtani, 12000, Thailand.

'-Celes' is an ancient Greek language suffix that means 'tumor,' 'hernia,' 'swelling,' or 'cavity.' There are many '-celes' in the abdomen and pelvis that may be encountered during routine imaging interpretation, including santorinicele, choledochocele, ureterocele, lymphocele, mucocele, rectocele, cystocele, peritoneocele, varicocele, spermatocele, hydrocele, hematocele, pyocele and syringocele. Most '-celes' are detected incidentally at imaging for other clinical indications, but some deserve more attention due to a range of clinical symptoms or functional disorder that can adversely affect patient quality of life. Read More

Colorectal Dis 2020 Apr 24. Epub 2020 Apr 24.

Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt.

Aim: Thorough assessment of obstructed defaecation syndrome (ODS) is imperative for the selection of treatment options. The present study aimed to examine the utility of the Mansoura Numeroalphabetic Constipation Score (MNCS) in distinguishing patients with ODS from healthy control subjects and in predicting the outcome of treatment of ODS.

Methods: Patients with ODS associated with anterior rectocele and/or rectoanal intussusception were assessed with the MNCS at the first visit to the clinic. Read More

Sci Rep 2020 Mar 27;10(1):5599. Epub 2020 Mar 27.

Department of Gynaecology, Peking University People's Hospital, Beijing, China.

We aimed to investigate the prevalence of true rectocele and obstructed defecation (OD) in patients with pelvic organ prolapse (POP), to investigate the correlation between true rectocele and OD, and to understand the diagnostic value of translabial ultrasound (TLUS) in the diagnosis of true rectocele. The patients who scheduled for POP surgery were enrolled in this study. Patients who had previous reconstructive pelvic surgery or repair of rectocele were excluded. Read More

Int Urol Nephrol 2020 Mar 16. Epub 2020 Mar 16.

Radiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Introduction: Treatment of pelvic organ prolapse (POP) associated with stress urinary incontinence (SUI) is a surgical challenge. Surgeons may perform combined prolapse and incontinence surgery or may correct prolapse first and evaluate incontinence afterwards. We present a prospective study to evaluate the effect of abdominal sacrocolpopexy (ASC) on urethral anatomy and continence using dynamic magnetic resonance imaging (MRI). Read More

Ann Coloproctol 2020 Mar 16. Epub 2020 Mar 16.

General Surgery Department, Istanbul Aydın Univercity, Istanbul, Turkey.

Purpose: Constipation is a common entity in society with various factors in the etiology. In this study, we evaluated the role of anal sphincter pressure of patients who refer to surgery clinic with complaint of constipation.

Methods: Sixty patients who refer to surgery clinic with complaint of constipation and were diagnosed with constipation due to Rome III criteria between July 2010 and September 2014. Read More

Ann Coloproctol 2020 Mar 16. Epub 2020 Mar 16.

Department of Surgery, Seoul Song Do Hospital, Seoul, Korea, Seoul, Korea.

Purpose: The aim of this study was to determine the accuracy and agreement of 3D pelvic floor ultrasonography with defecography in the assessment of posterior pelvic disorders.

Method: Eligible patients were consecutive women with undergoing 3D pelvic floor ultrasonography between August 2017 and February 2019 at one hospital. All 3D pelvic floor ultrasonography was performed by one examiner. Read More

Int Urogynecol J 2020 Mar 7. Epub 2020 Mar 7.

Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic, 9500 Euclid Ave, Desk A81, Cleveland, OH, 44195, USA.

Purpose: To determine if a concurrent posterior repair for an asymptomatic rectocele at the time of sacrocolpopexy reduces the incidence of surgical failure.

Methods: This is a retrospective chart review with a cross-sectional follow-up survey of all patients who underwent sacrocolpopexy from 2004 to 2014. Demographic and operative data were collected from the medical record. Read More

Minerva Chir 2020 Apr 29;75(2):83-91. Epub 2020 Jan 29.

Unit of General and Mini-Invasive Surgery, San Camillo Hospital, Trento, Italy.

Background: Different surgical techniques have been proposed for rectocele repair. However, controversial aspects exist on the best approach to use. The study aims to report the early and late outcomes of the sequential transfixed stich technique (STST) for the treatment of rectocele in the absence of mucosal prolapse. Read More

Dis Colon Rectum 2020 04;63(4):527-537

Colorectal Surgery Unit, Department of General Surgery, Mansoura University Hospitals, Mansoura University, Egypt.

Background: Methods of treatment of rectocele include transperineal, transvaginal, and transanal approaches and ventral rectopexy.

Objective: The present randomized study aimed to compare the outcome of transperineal repair and transvaginal repair of anterior rectocele.

Design: This is a randomized, single-blinded clinical trial. Read More

J Bodyw Mov Ther 2020 Jan 11;24(1):115-125. Epub 2019 Oct 11.

School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK. Electronic address:

Introduction: Pelvic organ prolapse (POP), the bulging of pelvic organs into the vagina, is a common condition thought to be caused by weak pelvic tissue. There is a paucity of evidence supporting current treatment approaches. This case series proposes a new biotensegrity-focused hypothesis that POP is caused by taut pelvic tissue and that releasing pelvic tension will improve POP. Read More

Tech Coloproctol 2020 01 11;24(1):65-73. Epub 2019 Dec 11.

Department of Surgery, School of Medicine, School of Medicine of the Federal University of Ceará, Av Atilano de Moura 430, Fortaleza, Ceará, 60810-180, Brazil.

Background: The aim of this study was to evaluate the impact of the transanal repair of rectocele and rectal mucosectomy with a single circular stapler (TRREMS) on the treatment of obstructed defecation due to rectocele and to identify the predictive factors for unsuccessful results.

Methods: Consecutive patients with obstructed defecation symptoms (ODS) associated with rectocele who had the TRREMS procedure were included. Each patient was assessed by echodefecography, manometry, and colonic transit time as well as the Cleveland Clinic constipation score (CCS) before therapy and at follow-up after 6 months. Read More

Tech Coloproctol 2020 01 9;24(1):1-3. Epub 2019 Dec 9.

Coloproctology Unit, Ospedale Regionale di Lugano, 6900, Lugano, Switzerland.

Ann Ital Chir 2019 ;90:447-450

Introduction: The conventional video colpo-cysto entero defecography describing the morpho- functional imaging features, physiological and pathological of the recto-anal region and pelvic floor . It represents the gold standard examination for the identification and staging of morphological and functional disorders of the recto-anal region and pelvic floor in evacuation dysfunctions.

Materials And Methods: Between January 2010 to January 2013 88 patients underwent STARR procedure for obstructed defecation syndrome (ODS) caused by single rectocele or internal rectal intussusception. Read More

Int J Gynaecol Obstet 2020 Mar 12;148(3):271-281. Epub 2020 Jan 12.

Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", Athens University Medical School, Athens, Greece.

Background: Recent systematic reviews have demonstrated wide variations on outcome measure selection and outcome reporting in trials on surgical treatments for anterior, apical and mesh prolapse surgery. A systematic review of reported outcomes and outcome measures in posterior compartment vaginal prolapse interventions is highly warranted in the process of developing core outcome sets.

Objective: To evaluate outcome and outcome measures reporting in posterior prolapse surgical trials. Read More

Female Pelvic Med Reconstr Surg 2019 Nov 18. Epub 2019 Nov 18.

Division of Female Pelvic Medicine and Reconstructive Surgery, Urology Institute.

Introduction: Malpractice litigations have significant implications for patients and physicians. Studies have investigated mesh litigations in female pelvic reconstructive surgery, but none on nonmesh pelvic organ prolapse (POP) surgery. Our purpose is to determine the reasons for and outcomes of medical malpractice after nonmesh POP surgery. Read More

Acta Chir Belg 2020 Jun 21;120(3):198-201. Epub 2019 Nov 21.

Digestive Surgery Department, Rouen University Hospital, Rouen, France.

The STARR (Stapled Trans-Anal Rectal Resection) procedure consists of a surgical correction of symptomatic rectocele refractory to medical treatment, involving anal dilatation. The aim of the study was to determine the impact of the STARR procedure on anal distensibility using EndoFLIP device. All female patients with a minimal rectocele of 3 cm and with symptoms of obstructed defecation syndrome (ODS) refractory to medical treatment were included prospectively. Read More

J Neurogastroenterol Motil 2020 Jan;26(1):128-132

Departments of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Background/aims: Colon transit time (CTT) test is regarded as the gold standard for evaluating colon transit function. Fluoroscopic defecography (FD) is a dynamic radiologic test to assess anorectal function. The aim is to evaluate the value of FD in constipated children with abnormal CTT test results. Read More

Pol Przegl Chir 2019 Oct;91(5):34-37

Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois, Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.

Rectal prolapse (RP) is often seen in patients over the age of fifty, particularly women. These patients frequently suffer from other concomitant pathologies like rectocele, sigmoidocele, cystocele, or even enterocele. Rectopexy with a mesh has been an established treatment for rectal prolapse. Read More

Neurourol Urodyn 2020 01 5;39(1):331-338. Epub 2019 Nov 5.

Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam, The Netherlands.

Aims: Oxygen plays a crucial role in wound healing after prolapse surgery. Trauma to the vaginal vasculature might limit the delivery of oxygen to the surgical wound, which may negatively affect wound healing and regeneration of connective tissue. This possibly increases the future risk of recurrence. Read More

Int J Gynaecol Obstet 2020 Feb 19;148(2):135-144. Epub 2019 Nov 19.

Department of Obstetrics and Gynecology, San Bartolo Hospital, Vicenza, Italy.

Background: The FIGO Working Group (FWG) in Pelvic Floor Medicine and Reconstructive Surgery (2012-2015) established a consensus among international opinion leaders in evaluating current evidence and providing practice recommendations.

Objectives: To provide an update of the previous clinical opinion report on conservative and surgical treatment of posterior compartment prolapse.

Search Strategy: Search of evidence was performed using Pubmed, Embase, and Cochrane Library databases up to August 2018. Read More

Curr Urol Rep 2019 Oct 14;20(11):70. Epub 2019 Oct 14.

Departments of Urology and Obstetrics & Gynecology, New York University School of Medicine, 222 East 41st Street, 11th Floor, New York, NY, 10017, USA.

Purpose Of Review: Due to recent concerns over the use of synthetic mesh in pelvic floor reconstructive surgery, there has been a renewed interest in the utilization of non-synthetic repairs for pelvic organ prolapse. The purpose of this review is to review the current literature regarding pelvic organ prolapse repairs performed without the utilization of synthetic mesh.

Recent Findings: Native tissue repairs provide a durable surgical option for pelvic organ prolapse. Read More

Gynecol Obstet Fertil Senol 2019 11 1;47(11):816-818. Epub 2019 Oct 1.

Département de gynécologie, hospices civils de Lyon, hôpital Femme-Mère-Enfant, HFME, 69000 Lyon, France.

J Formos Med Assoc 2019 Dec 18;118(12):1623-1632. Epub 2019 Sep 18.

Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan. Electronic address:

Background/purpose: The most suitable surgical technique for pelvic organ prolapse (POP) remains undetermined. The aim of this study was to compare clinical outcomes of the tailored transvaginal mesh (TVM) surgery and vaginal native tissue repair (NTR) surgery for POP.

Methods: Between November 2011 and August 2014, medical records of 339 women receiving POP surgeries were reviewed. Read More

Khirurgiia (Mosk) 2019 (8. Vyp. 2):32-39

Rostov State Medical University, Health Ministry of the Russian Federation, Rostov-on-Don, Russian Federation.

Aim: To objectify the criteria for choosing the method of treatment of anal fissures, to determine the indications for surgery and sphincterotomy.

Material And Methods: The results of treatment of 206 patients with chronic and acute anal fissures between the ages of 17 to 75 years are analyzed. The posterior anal fissure was detected in 175 (84. Read More

Abdom Radiol (NY) 2019 Sep 7. Epub 2019 Sep 7.

Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9085, USA.

Purpose: To compare prevalence and severity of multi-compartment pelvic floor dysfunction between supine magnetic resonance defecography with defecation (MRD) and supine dynamic MRI during Valsalva, both with and without rectal distention.

Methods: This was an IRB-approved, HIPAA-compliant retrospective review of consecutive patients referred for MR Defecography. MRD protocol included imaging at rest, during pre-defecation Valsalva (Pre-DV), defecation (Def), and post-defecation Valsalva (Post-DV). Read More

Int J Colorectal Dis 2019 Oct 30;34(10):1681-1687. Epub 2019 Aug 30.

Department of Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa City, Chiba, 296-8602, Japan.

Purpose: Fecal incontinence (FI) is common in patients with rectal intussusception (RI), although the mechanism behind its formation is unclear. Recent data indicate that a reduction in internal sphincter tone may cause FI, which becomes notable with increasing RI levels. However, the roles of other anatomical abnormalities in anal function remain unclear. Read More

Colorectal Dis 2020 Feb 12;22(2):178-186. Epub 2019 Sep 12.

Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Chiba, Japan.

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. Read More

Tech Coloproctol 2019 10 26;23(10):1017-1018. Epub 2019 Aug 26.

National Bowel Research Centre, Blizard Institute, Centre for Surgery and Trauma, Queen Mary University of London, London, UK.

Ther Adv Urol 2019 Jan-Dec;11:1756287219868593. Epub 2019 Aug 8.

Concord Hospital Center for Urologic Care, Geisel School of Medicine at Dartmouth, NH, USA.

Background: Our aim was to investigate longer-term surgical and quality of life (QOL) outcomes in a cohort of women undergoing robotic-assisted laparoscopic sacrocolpopexy (RALS) for pelvic organ prolapse (POP).

Methods: We performed a retrospective cohort study at a single institution of female patients undergoing RALS with and without concomitant robotic-assisted laparoscopic hysterectomy, urethral sling, and rectocele repair. Scores from the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) surveys were used to evaluate QOL outcomes. Read More

Zentralbl Chir 2019 Aug 14;144(4):402-407. Epub 2019 Aug 14.

Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland.

Discrimination between functional and morphological influences in obstructive defecation syndrome is challenging. The predictability of surgical success is still in discussion. Final understanding of the rectally induced variability in colonic motility is still missing, so that morphological changes cannot solely serve as indication. Read More

Zentralbl Chir 2019 Aug 14;144(4):387-395. Epub 2019 Aug 14.

Abteilung für Proktologie, Krankenhaus Barmherzige Brüder, Regensburg, Deutschland.

Obstructed defecation syndrome (ODS) is characterized by disturbed defecation, and morphological disorders can be differentiated from functional pathologies. Differential diagnosis from irritable bowel syndrome and slow transit constipation is frequently difficult. Most patients are female, and rectal intussusception and anterior rectocele are frequent morphological pathologies. Read More

Int Braz J Urol 2019 Sep-Oct;45(5):999-1007

Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Objective: To compare the intermediate-term follow-up results of laparoscopic pectopexy and vaginal sacrospinous fi xation procedures.

Materials And Methods: Forty-three women who had vaginal sacrospinous fixations (SSF) using Dr. Aksakal's Desta suture carrier and 36 women who had laparoscopic pectopexies were re-examined 7 to 43 months after surgery. Read More

Female Pelvic Med Reconstr Surg 2019 Apr 2. Epub 2019 Apr 2.

From the Department of Gynecology and Obstetrics, Division of Urogynecology, Stanford University Hospital, Palo Alto, CA.

Objectives: Our primary objective was to determine the association between rectocele size on defecography and physical examination in symptomatic patients. Our secondary objective was to describe the associations between both defecography and physical examination findings with defecatory symptoms and progression to surgical repair of rectocele.

Methods: We performed a retrospective review of all patients referred to a female pelvic medicine and reconstructive surgery clinic with a diagnosis of rectocele based on defecography and/or physical examination at a single institution from 2003 to 2017. Read More

Abdom Radiol (NY) 2019 Aug 2. Epub 2019 Aug 2.

Lahey Clinic Medical Center, Burlington, MA, USA.

Whether used as the primary diagnostic test or reserved as a problem-solving examination, fluoroscopic defecography (FD) remains an important tool in the workup and treatment of defecatory disorders. FD is a well-established, simple, and rapid examination that most closely resembles the actual process and position that a patient uses to enable defecation and provides both qualitative and quantitative information on the defecatory process. FD is indicated when re-creating the act of defecation is necessary, especially in patients with symptoms of obstructed defecation and where symptoms do not correlate with prior examinations such as MRI. Read More

Res Rep Urol 2019 19;11:179-188. Epub 2019 Jun 19.

Department of Surgery and Epidemiology & Biostatistics, Western University, London, Ontario, Canada.

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) affect many women in their lifetime. In this review, we describe and evaluate the latest treatment options for SUI and POP, including the controversy around transvaginal mesh (TVM) use. Growing evidence supports the utilization of pelvic floor muscle training as first-line treatment for both SUI and POP. Read More

Int Urogynecol J 2019 09 29;30(9):1433-1454. Epub 2019 Jun 29.

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Introduction And Hypothesis: Several posterior compartment surgical approaches are used to address posterior vaginal wall prolapse and obstructed defecation. We aimed to compare outcomes for both conditions among different surgical approaches.

Methods: A systematic review was performed comparing the impact of surgical interventions in the posterior compartment on prolapse and defecatory symptoms. Read More