STARR Trans-anal Resection Versus Vaginal Rectocele Repair Using Elevate: Effects on Defecatory Function

STARR Type Trans-anal Resection Versus Vaginal Rectocele Repair Using a Posterier Elevate Prothesis: a Randomized, Multicentric, Prospective Study on Defecatory Function

The primary objective of this study is to compare the function results between two methods for surgically repairing rectoceles: vaginal versus endo-anal surgery. Our working hypothesis is that the relatively new type of endo-anal surgery will result in better voiding function compared to the traditional vaginal surgery.

Inclusion Criteria:

• patient is not under any type of guardianship
• patient has a rectocele > 3 cm during defecography
• patient has persistent defecatory troubles depite medical treatment (laxatives for at least 1 month) and an ODS score > 10
• patient recieved information and signed the consent form

Exclusion Criteria:

• patient cannot read French
• patient has an asymptomatic rectocele
• patient with an enterocele at rest upon defecography, with opacification of the small bowel
• patient with non-rehabilitated anorectal asynchrony (anism)
• patient with anal incontinence, Wexner score > 7
• patient has a rectal lesion
• patient has previously had rectal surgery including a colorectal anastomosis
• patient has previously had a surgery involving disection of the rectovaginal wall, except for myorraphy of relever muscles
• patient has previously had pelvic radiotherapy
• anal sphincter insufficiency detected by rectomanometry
• megarectum detected by rectomanometry and defecography
• granule transit anomaly: > 70h
• exteriorized rectal prolapse
• rectovaginal fistule
• intestinal inflammatory disease
• anal stenosis
• anal or rectal tumor
• patient refuses to participate or refuses to sign consent
• patient is enrolled in another study
• contra indication for general or localized anesthesia
• patient does not have social security coverage