TY - JOUR
T1 - An update of a former FIGO Working Group Report on Management of Posterior Compartment Prolapse
AU - Doumouchtsis, Stergios K.
AU - Raheem, Ali Abdel
AU - Milhem Haddad, Jorge
AU - Betschart, Cornelia
AU - Contreras Ortiz, Oscar
AU - Nygaard, Christiana C.
AU - Medina, Carlos A.
AU - La Torre, Fillippo
AU - Iancu, George
AU - Cervigni, Mauro
AU - Zanni, Giuliano
N1 - Publisher Copyright:
© 2019 International Federation of Gynecology and Obstetrics
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
KW - Enterocele
KW - Posterior colporrhaphy
KW - Posterior compartment
KW - Posterior vaginal wall prolapse
KW - Rectocele
KW - Site specific defect-repair
KW - Transanal repair outcomes
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U2 - 10.1002/ijgo.13006
DO - 10.1002/ijgo.13006
M3 - Review article
C2 - 31628853
AN - SCOPUS:85075447568
VL - 148
SP - 135
EP - 144
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
SN - 0020-7292
IS - 2
ER -