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An update of a former FIGO Working Group Report on Management of Posterior Compartment Prolapse


Doumouchtsis, Stergios K; Raheem, Ali Abdel; Milhem Haddad, Jorge; Betschart, Cornelia; Contreras Ortiz, Oscar; Nygaard, Christiana C; Medina, Carlos A; La Torre, Fillippo; Iancu, George; Cervigni, Mauro; Zanni, Giuliano (2020). An update of a former FIGO Working Group Report on Management of Posterior Compartment Prolapse. International Journal of Gynaecology and Obstetrics, 148(2):135-144.

Abstract

BACKGROUND

The FIGO Working Group (FWG) in Pelvic Floor Medicine and Reconstructive Surgery (2012-2015) established a consensus among international opinion leaders in evaluating current evidence and providing practice recommendations.

OBJECTIVES

To provide an update of the previous clinical opinion report on conservative and surgical treatment of posterior compartment prolapse.

SEARCH STRATEGY

Search of evidence was performed using Pubmed, Embase, and Cochrane Library databases up to August 2018.

SELECTION CRITERIA

Controlled trials on posterior colporrhaphy, site-specific defect, transanal, abdominal, laparoscopic, and mesh repair.

DATA COLLECTION AND ANALYSIS

Collective consensus on surgical outcomes was based on a decision-making process during meetings and multiple group consultations.

MAIN RESULTS

Basic evaluation and conservative treatment precede surgical management. Surgical techniques are performed by vaginal, transperineal, transanal, abdominal, or laparoscopic approach. The transvaginal surgical route without mesh appears superior to the transanal route. No conclusions can be drawn based on clinical studies or randomized controlled trials of posterior colporrhaphy and laparoscopic rectopexy.

CONCLUSIONS

Management of rectocele should include patients' history, quality of life questionnaires, and, in case of complex anorectal symptoms, imaging and functional studies. Evidence on the best type of posterior vaginal wall repair is still scarce. Randomized controlled trials are needed to determine the best approach to achieve safe, effective, and long-term anatomical and functional outcomes.

Abstract

BACKGROUND

The FIGO Working Group (FWG) in Pelvic Floor Medicine and Reconstructive Surgery (2012-2015) established a consensus among international opinion leaders in evaluating current evidence and providing practice recommendations.

OBJECTIVES

To provide an update of the previous clinical opinion report on conservative and surgical treatment of posterior compartment prolapse.

SEARCH STRATEGY

Search of evidence was performed using Pubmed, Embase, and Cochrane Library databases up to August 2018.

SELECTION CRITERIA

Controlled trials on posterior colporrhaphy, site-specific defect, transanal, abdominal, laparoscopic, and mesh repair.

DATA COLLECTION AND ANALYSIS

Collective consensus on surgical outcomes was based on a decision-making process during meetings and multiple group consultations.

MAIN RESULTS

Basic evaluation and conservative treatment precede surgical management. Surgical techniques are performed by vaginal, transperineal, transanal, abdominal, or laparoscopic approach. The transvaginal surgical route without mesh appears superior to the transanal route. No conclusions can be drawn based on clinical studies or randomized controlled trials of posterior colporrhaphy and laparoscopic rectopexy.

CONCLUSIONS

Management of rectocele should include patients' history, quality of life questionnaires, and, in case of complex anorectal symptoms, imaging and functional studies. Evidence on the best type of posterior vaginal wall repair is still scarce. Randomized controlled trials are needed to determine the best approach to achieve safe, effective, and long-term anatomical and functional outcomes.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Obstetrics and Gynecology
Language:English
Date:February 2020
Deposited On:29 Jan 2020 14:03
Last Modified:29 Jul 2020 13:05
Publisher:Elsevier
ISSN:0020-7292
OA Status:Closed
Publisher DOI:https://doi.org/10.1002/ijgo.13006
PubMed ID:31628853

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