TRANSANAL APPROACH IN THE TREATMENT OF RECTOCELE. EXPERIENCE OF THE COLOPROCTOLOGY UNIT AT THE HOSPITAL UNIVERSITARIO dE CARACAS

Abstract

Objective: To determinate the efficient of the transanal approach technique to cure rectocele using the PPH machine. Study perform in the coloproctology unit at the Hospital Universitario de Caracas. Patients and method: A prospective, descriptive, study carried out on 62 women with rectocele and symptoms of outlet obstruction syndrome (OOS), between May 2.007 and April 2.009. Colonic transit time (CTT), move cecum and defecografy was done to each patient. Of these 62 patients, 20 were operated on using the transanal approach technique with the PPH machine and we determined the efficient of that. Results: Of these 62 patients studied, rectocele grade II occupied 77%, the mean symptom was incomplete evacuated sensation (74%), following of digitalization (41%) both symptoms of OOS. We found other pathologies associated like hemorrhoids (59.3%), cistocele (46%), intususcepcion or mucosal prolapse (49%). In all the patients operated we used the transanal aprroach with PPH machine 33mm; of these patients, 40% we did posterior time cure, 20% cecopexy and 5 % fistulotomy. A 59% improved the symptoms of OOS before 7 days and 41% between 7 and 15 days. A 45% of the patients had pain that relieved with AINES, 25% defecatory urgency and one patient stricture that was cure after. Conclusions: We demonstrated that the transanal approach technique for rectocele using the PPH machine had  low percentage of complications and good results.