Rectocele Repair with or Without Internal Sphincter Botulinum Toxin Injection: a Prospective Randomized Trial

Rectocele Repair with or Without Internal Sphincter Botulinum Toxin Injection: a Prospective Randomized Trial

This is a single-centre, prospective randomized controlled trial on female patients with anterior rectocele associated with obstructed defecation syndrome

Inclusion Criteria: all required

• female patients
• symptomatic rectocele
• failed conservative treatments for at least 3 months
• anterior rectocele larger than 3 cm in size in defecogram.
• retention of the contrast in the rectocele on defecography
• obstructed defecation manifestations: excessive straining, a sense of incomplete evacuation, the need for digital manipulation during defecation, or dyspareunia

Exclusion Criteria:

• significant urinary manifestations due to anterior vaginal wall prolapse
• recurrent rectocele
• previous anal surgery
• slow-transit constipation
• faecal incontinence (FI)
• abnormal thyroid functions
• patients under systemic steroid treatment
• patients with connective tissue disease
• ASA classification >3