Assessment of manometric results following posterior pericervical repair or level I to III surgical procedures

TL;DR

This study shows that posterior compartment surgery significantly improves bowel symptoms and prolapse in women with defecation disorders.

Contribution

The study provides empirical evidence on the effectiveness of DeLancey level 1 to 3 surgery for posterior compartment prolapse.

Findings

Surgery significantly improved manometric parameters like resting pressure and straining during defecation (p<0.001).

All patients showed improvement in posterior compartment prolapse grades after surgery (p<0.0001).

Symptoms improved over 12 months with no significant complications.

Abstract

Constipation and obstructive bowel disorders are the most common symptoms of prolapse and posterior defects. Prolapse and obstructive defecation disorders are treated using various surgical techniques to repair posterior defects. This study aimed to evaluate the manometry results of patients before and after reconstructive surgery of the posterior compartment. This retrospective cohort study included 40 women with defecation disorders referred to the Imam Khomeini Hospital Complex, an academic center affiliated with Tehran University of Medical Sciences, Tehran, Iran, from 2020 to 2021. Data were collected through medical records and a checklist developed by the researcher before and after surgery. All analyses were performed using SPSS software (version 26), with significance at p<0.05. Forty women with a mean age of 49.47±9.66 years participated in this study. The manometry results showed significant differences in patients before and after surgery in parameters such as maximum resting pressure, push test, constipation, straining during defecation, finger support necessity, sensation of incomplete defecation, dyspareunia, and husband’s sexual satisfaction (p<0.001). In addition, all patients had a grade 2 or higher posterior compartment prolapse, which improved in all cases after surgery (p<0.0001). Patients’ symptoms significantly improved during the 12-month follow-up after DeLancey level 3 to 1 surgery. This type of surgery proved to be an effective surgical intervention without significant complications in the short-term follow-up.