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Fraccalvieri D, Biondo S, Climent M, Kreisler E. Robotic ventral mesh rectopexy with anterior rectoplasty. Tech Coloproctol 2024; 28:63. [PMID: 38842639 DOI: 10.1007/s10151-024-02946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/16/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Doménico Fraccalvieri
- Colorectal Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, L'Hospitalet, Barcelona, Spain.
| | - Sebastiano Biondo
- Colorectal Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, L'Hospitalet, Barcelona, Spain
| | - Marta Climent
- Colorectal Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, L'Hospitalet, Barcelona, Spain
| | - Esther Kreisler
- Colorectal Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, L'Hospitalet, Barcelona, Spain
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Balci B, Leventoglu S, Osmanov I, Erkan B, Irkilata Y, Mentes B. Laparoscopic ventral mesh rectopexy vs. transperineal mesh repair for obstructed defecation syndrome associated with rectocele: comparison of selectively distributed patients. BMC Surg 2023; 23:359. [PMID: 38001430 PMCID: PMC10675873 DOI: 10.1186/s12893-023-02206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/24/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE Obstructed defecation syndrome represents 50-60% of patients with symptoms of constipation. We aimed to compare the two frequently performed surgical methods, laparoscopic ventral mesh rectopexy and transperineal mesh repair, for this condition in terms of functional and surgical outcomes. METHODS This study is a retrospective review of 131 female patients who were diagnosed with obstructed defecation syndrome, attributed to rectocele with or without rectal intussusception, enterocele, hysterocele or cystocele, and who underwent either laparoscopic ventral mesh rectopexy or transperineal mesh repair. Patients were evaluated for surgical outcomes based on the operative time, the length of hospital stay, operative complications, using prospectively designed charts. Functional outcome was assessed by using the Initial Measurement of Patient-Reported Pelvic Floor Complaints Tool. RESULTS Fifty-one patients diagnosed with complex rectocele underwent laparoscopic ventral mesh rectopexy, and 80 patients diagnosed with simple rectocele underwent transperineal mesh repair. Mean age was found to be 50.35 ± 13.51 years, and mean parity 2.14 ± 1.47. Obstructed defecation symptoms significantly improved in both study groups, as measured by the Colorectal Anal Distress Inventory, Constipation Severity Instrument and Patient Assessment of Constipation-Symptoms scores. Minor postoperative complications including wound dehiscence (n = 3) and wound infection (n = 2) occurred in the transperineal mesh repair group. CONCLUSION Laparoscopic ventral mesh rectopexy and transperineal mesh repair are efficient and comparable techniques in terms of improvement in constipation symptoms related to obstructed defecation syndrome. A selective distribution of patients with or without multicompartmental prolapse to one of the treatment arms might be the preferred strategy.
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Affiliation(s)
- Bengi Balci
- Department of Surgery, Memorial Ankara Hospital, Proctology Unit, Ankara, Turkey
| | - Sezai Leventoglu
- Department of Surgery, Faculty of Medicine, Gazi University Hospital, Ankara, Turkey.
| | - Igbal Osmanov
- Department of Surgery, Memorial Ankara Hospital, Proctology Unit, Ankara, Turkey
| | - Beyza Erkan
- Department of Surgery, Faculty of Medicine, Gazi University Hospital, Ankara, Turkey
| | | | - Bulent Mentes
- Department of Surgery, Memorial Ankara Hospital, Proctology Unit, Ankara, Turkey
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3
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Thorsen AJ. Management of Rectocele with and without Obstructed Defecation. SEMINARS IN COLON AND RECTAL SURGERY 2022. [DOI: 10.1016/j.scrs.2022.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Van den Broeck S, Jacquemyn Y, Hubens G, De Schepper H, Vermandel A, Komen N. Rectocele: victim of availability bias? Results of a Belgian survey of colorectal and gynecological surgeons. Int Urogynecol J 2022; 33:3505-3517. [PMID: 35201369 DOI: 10.1007/s00192-022-05118-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Women with a symptomatic rectocele may undergo different trajectories depending on the specialty consulted. This survey aims to evaluate potential differences between colorectal surgeons and gynecologists concerning the management of a rectocele. METHODS A web-based survey was sent to abdominal surgeons (CS group) and gynecologists (G group) asking about their perceived definition, diagnostic workup, multidisciplinary discussion (MDT) and surgical treatment of rectoceles. The answers of both groups were analyzed with the chi-square test or Fisher's exact test at p < 0.050. RESULTS A rectocele was defined as a prolapse of the posterior vaginal wall by 78% of the G and 41% of the CS group. All gynecologists and 49% of the CS group evaluated a rectocele clinically in dorsal decubitus, with 91% of gynecologists using a speculum and 65% using the Pelvic Organ Prolapse-Quantification (POP-Q) scoring system, compared to < 1/3 of colorectal surgeons. A digital rectal examination was performed by 90% of the CS group and 57% of the G group. A transvaginal ultrasound was only used by the G group, while anal manometry was opted for by the CS group (65%) and minimally by the G group (14%). In the G group, a posterior repair was the preferred surgical technique (78%), whereas 63% of the CS group preferred a rectopexy. Multidisciplinary discussions (MDT) were mostly organized ad hoc. CONCLUSIONS An availability bias is seen in different aspects of rectocele evaluation and treatment. Colorectal surgeons and gynecologists are acting based on their training and experience. Motivation for pelvic floor MDT starts with creating awareness of the availability bias.
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Affiliation(s)
- Sylvie Van den Broeck
- Department of Abdominal, Pediatric and Reconstructive Surgery, Antwerp University Hospital, Drie Eikenstraat 566, 2650, Edegem, Belgium. .,Antwerp ReSURG, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium.
| | - Yves Jacquemyn
- Antwerp ReSURG, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium.,Department of Obstetrics and Gynaecology, Antwerp University Hospital, 2650, Edegem, Belgium.,Global Health Institute (GHI), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Edegem, Antwerp, Belgium
| | - Guy Hubens
- Department of Abdominal, Pediatric and Reconstructive Surgery, Antwerp University Hospital, Drie Eikenstraat 566, 2650, Edegem, Belgium.,Antwerp ReSURG, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Heiko De Schepper
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, 2650, Edegem, Belgium
| | - Alexandra Vermandel
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Niels Komen
- Department of Abdominal, Pediatric and Reconstructive Surgery, Antwerp University Hospital, Drie Eikenstraat 566, 2650, Edegem, Belgium.,Antwerp ReSURG, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
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5
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The 121st Annual Scientific Meeting of the American Society of Colon and Rectal Surgeons: together again! Tech Coloproctol 2022; 26:837-839. [PMID: 35913686 PMCID: PMC9340762 DOI: 10.1007/s10151-022-02659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022]
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6
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ACG Clinical Guidelines: Management of Benign Anorectal Disorders. Am J Gastroenterol 2021; 116:1987-2008. [PMID: 34618700 DOI: 10.14309/ajg.0000000000001507] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 08/09/2021] [Indexed: 12/11/2022]
Abstract
Benign anorectal disorders of structure and function are common in clinical practice. These guidelines summarize the preferred approach to the evaluation and management of defecation disorders, proctalgia syndromes, hemorrhoids, anal fissures, and fecal incontinence in adults and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence for these guidelines was assessed using the Grading of Recommendations Assessment, Development and Evaluation process. When the evidence was not appropriate for Grading of Recommendations Assessment, Development and Evaluation, we used expert consensus to develop key concept statements. These guidelines should be considered as preferred but are not the only approaches to these conditions.
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Fathy M, Elfallal AH, Emile SH. Literature review of the outcome of and methods used to improve transperineal repair of rectocele. World J Gastrointest Surg 2021; 13:1063-1078. [PMID: 34621481 PMCID: PMC8462077 DOI: 10.4240/wjgs.v13.i9.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rectocele is commonly seen in parous women and sometimes associated with symptoms of obstructed defecation syndrome (ODS).
AIM To assess the current literature in regard to the outcome of the classical transperineal repair (TPR) of rectocele and its technical modifications.
METHODS An organized literature search for studies that assessed the outcome of TPR of rectocele was performed. PubMed/Medline and Google Scholar were queried in the period of January 1991 through December 2020. The main outcome measures were improvement in ODS symptoms, improvement in sexual functions and continence, changes in manometric parameters, and quality of life.
RESULTS After screening of 306 studies, 24 articles were found eligible for inclusion to the review. Nine studies (301 patients) assessed the classical TPR of rectocele. The median rate of postoperative improvement in ODS symptoms was 72.7% (range, 45.8%-83.3%) and reduction in rectocele size ranged from 41.4%-95.0%. Modifications of the classical repair entailed omission of levatorplasty, addition of implant, concomitant lateral internal sphincterotomy, changing the direction of plication of rectovaginal septum, and site-specific repair.
CONCLUSION The transperineal repair of rectocele is associated with satisfactory, yet variable, improvement in ODS symptoms with parallel increase in quality-of-life score. Several modifications of the classical TPR were described. These modifications include omission of levatorplasty, insertion of implants, performing lateral sphincterotomy, changing the direction of classical plication, and site-specific repair. The indications for these modifications are not yet fully clear and need further prospective studies to help tailor the technique to rectocele patients.
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Affiliation(s)
- Mohammad Fathy
- General Surgery, Mansoura University Faculty of Medicine, Mansoura 35516, Egypt
| | | | - Sameh Hany Emile
- General Surgery, Mansoura University Faculty of Medicine, Mansoura 35516, Egypt
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Abdelnaby M, Fathy M, Abdallah E, Balata M, Arnous M, Mikhail HM, Emile SH. Laparoscopic Ventral Mesh Rectopexy Versus Transvaginal Posterior Colporrhaphy in Management of Anterior Rectocele. J Gastrointest Surg 2021; 25:2035-2046. [PMID: 33051805 DOI: 10.1007/s11605-020-04823-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/03/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Management of rectocele is challenging. Treatment usually starts with conservative measures and may involve surgical intervention in non-responding patients. We compared the outcomes of transvaginal posterior colporrhaphy (PC) and laparoscopic ventral mesh rectopexy (LVMR) in treatment of anterior rectocele. METHODS Patients with anterior rectocele who underwent PC or LVMR were functionally assessed using Cleveland Clinic Constipation Score (CCCS) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Pelvic Organ Prolapse Quantification System (POP-Q) was used for clinical assessment, defecography for anatomic assessment, and manometry for physiologic assessment. In addition, quality of life was assessed. RESULTS A total of 231 female patients with a mean age of 39 years were included to the study. One hundred fifty-nine underwent PC and 72 underwent LVMR. The LVMR group showed significantly a better functional outcome as compared with the PC group (p < 0.0001). The mean of CCCS at 1 year after LVMR was 6 ± 2.3 vs 9.2 ± 1.2 after PC. The mean of PISQ-12 at 1 year after LVMR was 39.3 ± 2.8 vs 35.8 ± 2.2 after PC. LVMR showed better anatomic correction by defecography, had significantly higher quality of life scores, and had a longer operative time as compared with PC, yet with comparable incidence of complications. CONCLUSION PC and LVMR are both effective treatment options for treatment of rectocele. LVMR was associated with better anatomic correction and greater improvement in constipation, sexual symptoms, and quality of life compared with PC. Although LVMR had a longer operation time than PC, the complication rate of the two procedures was comparable.
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Affiliation(s)
- Mahmoud Abdelnaby
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohammad Fathy
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Emad Abdallah
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohamed Balata
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohamed Arnous
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Hany Maurice Mikhail
- General Surgery Department, Qasr Al-Ainy Hospitals, Cairo University, Giza, Egypt
| | - Sameh Hany Emile
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt.
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9
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Pla-Martí V, García-Botello S, Pérez-Santiago L, Martín-Arévalo J, Moro-Valdezate D, Espí-Macías A. Transvaginal rectocele repair reinforced with biological mesh - a video vignette. Colorectal Dis 2021; 23:1938. [PMID: 33811798 DOI: 10.1111/codi.15664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/05/2021] [Accepted: 03/23/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Vicente Pla-Martí
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
| | - Stephanie García-Botello
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
| | - Leticia Pérez-Santiago
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain
| | - José Martín-Arévalo
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain
| | - David Moro-Valdezate
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
| | - Alejandro Espí-Macías
- Department of Colorectal Surgery, University Clinic Hospital of Valencia, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
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10
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Uribe N, Balciscueta Z, Tabet J, Martín MC, López M. Transvaginal rectocele repair with biological mesh - a video vignette. Colorectal Dis 2021; 23:1936. [PMID: 33793034 DOI: 10.1111/codi.15660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Natalia Uribe
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - Zutoia Balciscueta
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - Janine Tabet
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - M Carmen Martín
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - Manuel López
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
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11
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Maeda K, Honda K, Koide Y, Katsuno H, Hanai T, Masumori K, Matsuoka H, Endo T, Cheong YC. Outcomes of Transvaginal Anterior Levatorplasty with Posterior Colporrhaphy for Symptomatic Rectocele. JOURNAL OF THE ANUS RECTUM AND COLON 2021; 5:137-143. [PMID: 33937553 PMCID: PMC8084542 DOI: 10.23922/jarc.2020-062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
Objectives: To clarify the long-term outcomes of transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele with defecographic changes. Methods: Consecutive patients undergoing transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele were prospectively registered and retrospectively reviewed using medical records. Symptoms, fecal incontinence, and defecographic findings were evaluated before and after surgery. Results: Fifty-seven women (mean age, 68 years) were identified, and the median disease duration was 24 months. Symptoms of vaginal mass (n = 32) and difficult defecation (n = 21) disappeared (90.6% and 71.4%, respectively) or improved (6.3% and 28.6%, respectively) after surgery. However, the feeling of residual stool was unchanged in two of eight patients. Seventeen patients who performed digitation on defecation before surgery discontinued digitation after surgery. The proportion of patients who had fecal incontinence preoperatively (40.4%) decreased significantly after surgery (17.5%) during a median follow-up period of 47 months. Defecography revealed a disappearance or improvement of rectocele in all 18 patients examined. The average rectocele size decreased significantly in six improved patients (p = 0.0006, paired t-test). Conclusions: Transvaginal anterior levatorplasty with posterior colporrhaphy for symptomatic rectocele was a useful option to improve symptoms and anatomical disorders in the long term, but it had limitations in improving defecatory symptoms.
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Affiliation(s)
- Kotaro Maeda
- International Medical Center Fujita Health University Hospital, Toyoake, Japan
| | | | - Yoshikazu Koide
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hidetoshi Katsuno
- Department of Surgery, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Tsunekazu Hanai
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Koji Masumori
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroshi Matsuoka
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tomoyoshi Endo
- Department of Surgery, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Yeong Cheol Cheong
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
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Omar W, Elfallal AH, Emile SH, Elshobaky A, Fouda E, Fathy M, Youssef M, El-Said M. Horizontal versus vertical plication of the rectovaginal septum in transperineal repair of anterior rectocele: a pilot randomized clinical trial. Colorectal Dis 2021; 23:923-931. [PMID: 33314521 DOI: 10.1111/codi.15483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/09/2020] [Accepted: 12/05/2020] [Indexed: 12/19/2022]
Abstract
AIM Anterior rectocele is usually an asymptomatic condition in many women, yet it can be associated with obstructed defaecation syndrome (ODS). Transperineal repair of rectocele (TPR) has been followed by variable rates of improvement in ODS. The present pilot randomized clinical trial aimed to evaluate the outcome of TPR with vertical plication (VP) of the rectovaginal septum compared to horizontal plication (HP). METHODS Adult women with anterior rectocele were recruited to the study and were randomly allocated to one of two equal groups. The first group underwent TPR with VP of the rectovaginal septum and the second group underwent TPR with HP. The main outcome measures were improvement in ODS, recurrence of rectocele, complications and dyspareunia. RESULTS The trial included 40 female patients with anterior rectocele. There was no significant difference between the two groups regarding the postoperative Wexner score. Complete cure and significant improvement in ODS symptoms were comparable after the two techniques. The reduction in rectocele size after HP was significantly greater than after VP (1.7 vs. 2.6, P < 0.0001). Significant improvement in dyspareunia was recorded after HP (P = 0.001) but not after VP (P = 0.1). There was no significant difference between the two groups with regard to operating time, complications and recurrence. CONCLUSION VP and HP of the rectovaginal septum in TPR were associated with a comparable improvement in ODS symptoms and similar complication rates. HP was followed by a greater reduction in the rectocele size and greater improvement in dyspareunia than VP.
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Affiliation(s)
- Waleed Omar
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Ahmed Hossam Elfallal
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Sameh Hany Emile
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Ayman Elshobaky
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Elyamani Fouda
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Mohammad Fathy
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Mohamed Youssef
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
| | - Mohamed El-Said
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt
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Functional and sexual outcome of laparoscopic ventral mesh rectopexy vs transperineal mesh repair in the treatment of rectocele: a retrospective analysis. Eur Surg 2021. [DOI: 10.1007/s10353-021-00695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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