FIELD: medicine.
SUBSTANCE: two-staged surgical management of rectocele is performed. A rectovaginal space is approached transvaginally by a long incision along the midline of a posterior wall of the vagina from the vaginal vestibule to the uterine cervix. An anterior wall of the rectus and the right sacrospinal ligament is mobilised. The right sacrospinal ligament is sutured edgewise with the first non-absorbable interrupted suture in the mid-length. The right cardinal ligament is mobilised at the base of the uterine cervix and sutured edgewise with a second non-absorbable interrupted suture. The cardinal ligament is pulled up to the sacrospinal ligament. The sutures are tied together. The transvaginal wound is closed through all the layers by the Reverdin uninterrupted suture. An anoscope is inserted transanally. An uninterruped blanket suture 4 to 6 cm long is applied longwise in the 11 o'clock position at 0.5 cm in the proximal direction from the dentate line on the rectal mucosa.
EFFECT: method simplifies the surgical management of rectocele, reduces injuries and the number of recurrences, reduces a risk of complications of dyspareunea and obstructive defecation.
2 ex
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Authors
Dates
2014-12-10—Published
2013-11-06—Filed