A short-term independent audit of mesh repair for the treatment of rectocele in women, using 3-dimensional volume ultrasound: a pilot study
Christopher Barry, Hans Peter Dietz, Yik Nyok Lim, Ajay Rane
The aim of this study was to determine if three-dimensional ultrasound (3-DUS) could be used to assess the outcome of rectocele repair. This was a retrospective, observational study using transperineal 3-DUS on 71 women who had undergone rectocele repair using a mesh overlay technique. The severity of the rectocele was assessed at the time of surgery and at follow-up. Ultrasound examination was undertaken independently with a standardised review of associated urinary and bowel symptomatology. Results showed there was no correlation between levator dimensions or perineal mobility with age, parity, follow-up time or symptoms of bowel dysfunction. Nor was there any correlation between such symptoms and persistence of a fascial defect on ultrasound which were evident in over 20% of patients. There was a moderate negative correlation between levator hiatal area on Valsalva and descent of the rectal ampulla, as well as clinical and ultrasound evidence of rectocele recurrence. It was concluded that 3-DUS of the pelvic floor offered an independent and objective assessment of the outcomes of pelvic floor surgery.