This study reports the 2-year results of an original technique for
rectocele repair by the vaginal route, using a combined sacrospinous
suspension and a
polypropylene mesh. Twenty-six women were successively operated between October 2000 and February 2003. Mean age was 63.7 years [range 35-92]. 19 women had had previous pelvic surgery for
prolapse and/or
urinary incontinence (73.1%), but none had had a previous
rectocele repair. Patients underwent physical examination staging of
prolapse in the international
pelvic organ prolapse staging system. Eleven women had stage 2 posterior vaginal wall
prolapse (42.3%), seven had stage 3 (26.9%) and eight had stage 4 (30.8%). The procedure included a bilateral sacrospinous
suspension and a
polypropylene mesh (GyneMesh, Gynecare, Ethicon France) attached from the sacrospinous ligaments to the perineal body. We did not perform any associated posterior fascial repair, nor myorraphy. Patients were followed up for 10-44 months, with a median follow-up (+/- SD) of 22.7 +/- 9.2 months. Functional results and sexual function were evaluated using the PFDI, the PFIQ and the PISQ-12 self-questionnaires. Twenty-five women returned for follow-up (96.2%). At follow-up, 24 women were cured (92.3%) and one had asymptomatic stage 2
rectocele. All the patients but one had symptoms and impact on quality of life improved. No postoperative
infection of the mesh or
rectovaginal fistula was found, but there were three vaginal erosions (12%) and one out of 13 had de novo
dyspareunia (7.7%).