Transanal repair of rectocele: prospective assessment of functional outcome and quality of life

Colorectal Dis. 2020 Feb;22(2):178-186. doi: 10.1111/codi.14833. Epub 2019 Sep 12.


Aim: This study aimed to assess the functional outcome of transanal repair of rectocele using patient symptom scores and quality of life (QOL) instruments.

Method: Patients who underwent transanal repair for symptomatic rectocele between February 2012 and August 2017 were included. This study was a retrospective analysis of prospectively collected data. A standard questionnaire including the Constipation Scoring System (CSS), the Fecal Incontinence Severity Index (FISI) and QOL instruments [Patient Assessment of Constipation (PAC)-QOL, Fecal Incontinence QOL Scale, Short-Form 36 Health Survey (SF-36)] was administered before and after the operation. Physiological assessment and proctography were performed before and after the operation.

Results: Thirty patients were included. The median follow-up was 36 (6-72) months. Postoperative proctography showed a reduction in rectocele size [34 mm (14-52 mm) vs 10 mm (0-28 mm), P < 0.0001]. Physiological assessment showed no significant postoperative changes. Constipation was improved in 15/21 patients (71%) at 1 year and 14/20 patients (70%) at the mid-term follow-up. The CSS score reduced at 3 months [12 (8-12) vs 6 (1-12), P < 0.0001] and remained significantly reduced over time until the mid-term follow-up. Faecal incontinence was improved in two-thirds patients at 1 year. Four patients developed new-onset faecal incontinence. All the PAC-QOL scale scores significantly improved over time until 1 year, while two of the eight SF-36 scale scores showed significant postoperative improvement.

Conclusion: Transanal repair for rectocele improves constipation and constipation-specific QOL.

Keywords: Functional results; quality of life; rectocele; transanal repair.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Constipation / etiology
  • Constipation / physiopathology*
  • Fecal Incontinence / etiology
  • Fecal Incontinence / physiopathology*
  • Female
  • Humans
  • Middle Aged
  • Pelvic Floor / physiopathology
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology*
  • Prospective Studies
  • Quality of Life*
  • Rectocele / physiopathology
  • Rectocele / surgery*
  • Rectum / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Transanal Endoscopic Surgery / adverse effects*
  • Transanal Endoscopic Surgery / methods
  • Treatment Outcome