Polyethylene Terephlatate Grafts for Repair of Enteroceles and Rectoceles

摘要

Objective: This paper will describe one general obstetric and gynecologic group's experience using an elastic polyethylene terephlatate (PETP) woven fabric for the treatment/repair of entero-celes and rectoceles.Method: A retrospective chart review and ongoing observational evaluation of 36 enterocele and/or rectocele repairs were conducted from March 1998 to current date. Data collected included patient age, body mass index (BMI), preoperative and postoperative symptoms, preoperative diagnosis, and evaluation of prolapse including pelvic organ prolapse scores, concomitant procedures, parity, and date of last follow up. In each case, all surgical procedures were performed by the same surgeon and surgical assistant using identical technique in the same facility.Results: Repairs of enteroceles/rectoceles were performed using elastic PETP woven fabric grafts in 36 Caucasian females whose mean age was 59 years, BMI mean was 24.6, and parity mean was 2.2 with no nulligravidas in the study. Median length of follow up after surgery for patients was 9.9 months. No wound infection occurred. Two erosions of material at the vaginal apex were observed. One case was a concomitant hysterectomy and colposacro-pexy. In the second, a colposacropexy without hysterectomy was performed. The PETP fabric was used for all colposacropexies. There has been no recurrence of rectocele or enterocele to date. Preoperative symptoms of pressure, perineal pain, constipation, splinting, dyspareunia were resolved. No formation of posterior vaginal shelf or vaginal shortening has been observed nor have there been patient reports of induced perineal, vaginal, or adnexal pain. Patients reported normal bowel and sexual function. Three patients were lost to follow up.Conclusion: PETP elastic woven fabric graft material used for repair of enteroceles and rectoceles is effective and is associated with minimal immediate postoperative morbidity.