Obstructed Defecation Syndrome and Rectocele Repair Using Transperineal Bioabsorbable Mesh

Rectocele is a common functional pelvic floor disorder. Its main symptoms are prolonged straining and splinting. Most patients remain asymptomatic. However, symptomatic cases may require surgery. Debates are still ongoing about the optimal surgical approach. Nevertheless, pelvic approaches gained attention especially in old and fragile patients. However, optimal pelvic approach and how it should be performed is still an ongoing debate. In this study we aimed to provide our transperineal rectocele repair experience and 1 year follow-up results.. The outcomes of 50 patients, who underwent transperineal rectocele repair with bioabsorbable mesh augmentation and whose data were recorded prospectively for 1 year, were analyzed in terms of peroperative complications, relief of symptoms, recurrence and new onset dyspareunia. No severe peroperative complications or fecal incontinence were reported. Mild bleeding and surgical site infection were reported in 18% and 14% of patients, respectively. 88% of patients reported total relief of symptoms on first year follow-up, while 8% had no improvement after the surgery and 4% had recurrence. Transperinal rectocele repair with bioabsorbable mesh augmentation is a simple, safe and successful surgical procedure. However, more studies are required to determine its superiority to other pelvic and transabdominal approaches.