Changes in Bowel Function following Transanal and Transvaginal Rectocele Repair

AIM: This study was designed to compare preoperative and postoperative bowel functions in patients with rectocele repair. METHODS: Patients who underwent surgery for rectocele between October 1988 and October 2004 were enrolled. Prior to surgery, the patients were asked to complete a questionnaire regarding evacuation difficulty, itching, fecal incontinence, and the need for digitation. Surgery was performed either transanally (group I) or transvaginally (group II). At follow-up after 12 months, the same questionnaire was obtained in the outpatient clinic or by mail to evaluate preoperative and postoperative changes in bowel function. RESULTS: There were 71 patients in group I and 40 patients in group II. The median age was 56 years in group I and 67 years in group II. The evacuation difficulty was significantly improved in both group I (p < 0.001) and group II (p < 0.001). Incontinence to flatus was slightly increased in group I (p = 0.33) and group II (p = 0.6). Incontinence to solid stool was not statistically different in either group. The need for digitation was markedly improved in group I (p < 0.001) and group II (p = 0.0017). CONCLUSION: Although surgery for rectocele potentially increases the risk of fecal incontinence, it may be indicated if presented with evacuation difficulty necessitating digitation.