Long-Term Outcomes of Rectocele Repair With Chemically Processed (Tutoplast) Fascia Lata

In Brief Objective: To assess the long-term outcomes of rectocele repair using chemically processed cadaveric fascia lata (Tutoplast). Methods: After Institutional Review Board approval, a retrospective chart review of all patients who underwent rectocele repair with Tutoplast fascia lata was done. Modified Pelvic Organ Prolapse/Urinary Incontinence Sexual function Questionnaire was then mailed to all patients to assess the postoperative sexual function and vaginal bulge. Outcomes were measured according to the postoperative follow-up data and the questionnaire results. Cure was defined as postoperative grade 0 rectocele according to Baden-Walker classification; improvement meant a lower grade rectocele than preoperatively, while same or higher grade rectocele than preoperative one was considered failure. Results: Forty-one patients were included in this study with a mean age of 62.6 years and mean parity of 2.6. Twenty 2 (53.5%) patients had previous hysterectomy and 4 (9.8%) had previous failed rectocele repair. Preoperative rectocele grade was grade I in 8 (19.5%) patients, grade II in 29 (70.7%), and grade III in 4 (9.8%). After a mean follow-up of 2.5 (1.5–6) years, 40 patients (97.55%) were cured and 1 (2.45%) improved. Thirty patients replied the modified Pelvic Organ Prolapse/Urinary Incontinence Sexual function Questionnaire (73% response rate) and reported improvement in all the individual domains and absence of the vaginal bulge compared with the preoperative status. Postoperative complications included vaginal infection in 7 patients (17.1%), constipation in 4 (9.8%), dyspareunia in 2 (6.6%), and vaginal hematoma in 1 (2.45%). None of the patients had graft exposure. Conclusion: Rectocele repair using Tutoplast facia lata is a safe and effective procedure with minimal complications. We present here our experience in rectocele repair using chemically processed Tutoplast fascia lata. Forty one women with symptomatic rectocele had undergone this technique. After 2.5 years follow up, significant improvement was found in 97.5% of cases with a very low complication rate.