eMedicine Specialties > Obstetrics and Gynecology > Prolapse and Incontinence

Relaxed Vaginal Outlet: Follow-up

Author: R Duane Cespedes, MD, Residency Program Director, Director of Female Urology and Urodynamics, Department of Urology, Wilford Hall Medical Center; Clinical Associate Professor, Department of Surgery, Division of Urology, University of Texas Health Science Center at San Antonio
Coauthor(s): Javier L Arenas, MD, Resident Physician, Department of Urology, San Antonio Uniformed Services Health Education Consortium Residency Program, Wilford Hall Medical Center
Contributor Information and Disclosures

Updated: Dec 22, 2008

Outcome and Prognosis

The long-term results of traditional and site-specific rectocele repairs appears to be between 80% and 95% in various series. Long-term results using reinforcing materials in rectocele repairs have not been adequately studied; however, 1 small series reported an 84% cure rate using polypropylene mesh.33

Site-specific repairs in which only the focal areas of weakness are repaired have recently been shown to have a slightly lower cure rate than the traditional posterior repair as described above. In most cases, the posterior fascial defect is continuous from the most proximal extent of the defect all the way down to the perineal body.

Future and Controversies

Reinforcing materials appears to provide good short-term resolution; however, long-term follow-up studies are still needed. Current literature documents better results using cadaveric or synthetic implant over porcine in selected patients with large rectoceles, poor tissue strength, or symptomatic recurrences.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Gregory Lacy, MD to the development and writing of this article.



More on Relaxed Vaginal Outlet

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Treatment: Relaxed Vaginal Outlet
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References
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Further Reading

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Keywords

relaxed vaginal outlet, relaxed perineum, perineoplasty, vaginal prolapse, pelvic prolapse, uterine prolapse, urethral hypermobility, cystocele, rectocele, enterocele, perineal relaxation, pelvic floor relaxation, perineorrhaphy

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Contributor Information and Disclosures

Author

R Duane Cespedes, MD, Residency Program Director, Director of Female Urology and Urodynamics, Department of Urology, Wilford Hall Medical Center; Clinical Associate Professor, Department of Surgery, Division of Urology, University of Texas Health Science Center at San Antonio
R Duane Cespedes, MD is a member of the following medical societies: Alpha Omega Alpha and American Urological Association
Disclosure: Nothing to disclose.

Coauthor(s)

Javier L Arenas, MD, Resident Physician, Department of Urology, San Antonio Uniformed Services Health Education Consortium Residency Program, Wilford Hall Medical Center
Javier L Arenas, MD is a member of the following medical societies: American Medical Association and American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey B Garris, MD, Chief, Assistant Professor, Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Tulane University School of Medicine
Jeffrey B Garris, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American Medical Association, American Urological Association, Association of Professors of Gynecology and Obstetrics, Louisiana State Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David Chelmow, MD, Professor of Obstetrics and Gynecology, Tufts University School of Medicine; Program Director, Tufts University Affiliated Hospitals OB/GYN Residency Program; Chair, Tufts University Health Sciences Campus Institutional Review Board
David Chelmow, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, Phi Beta Kappa, Sigma Xi, Society for Gynecologic Investigation, and Society for Medical Decision Making
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

David Chelmow, MD, Professor of Obstetrics and Gynecology, Tufts University School of Medicine; Program Director, Tufts University Affiliated Hospitals OB/GYN Residency Program; Chair, Tufts University Health Sciences Campus Institutional Review Board
David Chelmow, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, Phi Beta Kappa, Sigma Xi, Society for Gynecologic Investigation, and Society for Medical Decision Making
Disclosure: Nothing to disclose.

 
 
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