Modern surgical methods of rectocele treatment – laser method
https://doi.org/10.17238/2072-3180-2026-1-54-60
Abstract
Introduction. Surgical treatment of rectocele by traditional methods (muscle plastic surgery and resection of stretched mucosa) is characterized by the risk of complications in the form of bleeding, suppuration, suture divergence (17–30 %), the frequency of relapses (5–35 %), unsatisfactory treatment results (5–85 %). It is characterized by technical complexity and duration of operations, low quality of life in the immediate postoperative period, long-term rehabilitation. These facts determine the need to search for new solutions in surgical tactics of the disease with improved results and increased treatment efficiency.
Purpose of the study. To study the efficiency and safety of a new method of surgical treatment of rectocele – combined laser correction of rectocele.
Materials and methods. Study group: 72 patients with lower anterior rectocele of 1–2 degrees. All patients were women aged 28 to 72 years. Exclusion criteria: severe concomitant pathology, purulent diseases of the anal canal. Most patients had concomitant hemorrhoids of stages 1, 2, 3, 4.
Surgical treatment was performed under intravenous anesthesia with the addition of local anesthesia. Laser radiation of a diode device with a wavelength of 1,56 mkm and a power of 10 W was used.
Results. Low (up to 5 points on VAS in 90 %) and short-term (taking NSAIDs 1–2 times a day for no more than 10 days in 90 %) postoperative pain syndrome. Rare complications (2 % of bleeding due to non-compliance, skin fringes). Satisfactory rehabilitation periods (30–40 days in 90 %). High quality of life in the immediate postoperative period. Low percentage of relapse during observation for 1 year (less than 5 %). High satisfaction with treatment (more than 95 %).
Conclusion. The method has significant prospects for use in patients with initial stages of lower rectocele. It is characterized by high efficiency and safety. It can be used in outpatient surgery. It has no significant limitations if the rules for selecting patients for treatment are followed. It is simple and fast in technical execution.
About the Authors
M. Yu. Cherepenin
Elena Malysheva Medical Center; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Cherepenin Mikhail Yuryevich – Candidate of Medical Sciences, Head of the Laser Surgery Center; Assistant of the Department of General Surgery of the Faculty of Medicine
117997 Moscow, 1 Ostrovityanova str.
I. V. Lutkov
Elena Malysheva Medical Center
Russian Federation
Russian Federation
Lutkov Ivan Viktorovich – Candidate of Medical Sciences, coloproctologist;, Head of the Elena Malysheva Educational Center
105082, Moscow, lane Perevedenovskiy, 8
V. A. Gorsky
Pirogov Russian National Research Medical University; NCC № 2, B.V. Petrovsky Russian Scientific Center of Surgery
Russian Federation
Russian Federation
Gorsky Viktor Aleksandrovich – Doctor of Medical Sciences, Professor of the Department of Experimental and Clinical Surgery of the Faculty of Medicine and Biology
117997 Moscow, 1 Ostrovityanova str.
O. E. Bashkurov
ProMedClinic Medical Center
Russian Federation
Russian Federation
Bashkurov Oleg Evgenievich – MD, PhD, Chief Physician of the ProMedClinic Medical Center, proctologist, surgeon, and oncologist
603000, Nizhny Novgorod Region, Nizhny Novgorod, Maxim Gorky str., 43, room p15
References
1. Abrams P., Cardozo L., Khoury S., Wein A. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal incontinence (AI). Incontinence. 5th International Consultation on Incontinence. Paris: Health Publication Ltd, 2013, 1956 р.
2. Kopenkin D.A., Vasilyeva T.V., Shishmentsev N.B. Historical aspects and modern prospects of surgical treatment of rectocele. Bulletin of the Council of Young Scientists and Specialists of the Chelyabinsk region, 2016, vol. 2, № 2, pр. 68–70 (In Russ.)
3. Neal C.E., Essani R. Treatment of Obstructed Defecation. Clinics in Colon and Rectal Surgery, 2012, № 25(1), рр. 24–33. https://doi.org/10.1055/s-0032-1301756
4. Fomenko O.Yu., Shelygin Yu.A., Popov A.A. and others. The functional state of the pelvic floor muscles in patients with rectocele. Russian Bulletin of Obstetrician-gynecologist, 2017, vol. 17, № 3, pp. 43–48. (In Russ.)
5. Chechneva M.A., Buyanova S.N., Shchukina N.A. Ultrasound diagnostics of genital prolapse and its complications in women. SonoAce Ultrasound, 2012, № 23, pp. 25–33. (In Russ.)
6. Orazov M.R., Mikhaleva L.M., Krestinin M.V., Soyunov M.A. Risk factors for rectocele in women of reproductive age. Clinical review in general medicine, 2023, № 9. (In Russ.)
7. Dos Santos R.G.M., Pepicelli F.C.A., Batista N.C., de Carvalho C.V., Bortolini M.A.T., Castro R.A. Collagen XVIII and LOXL-4 polymorphisms in women with and without advanced pelvic organ prolapse. Int Urogynecol J, 2018, № 29, рр. 893–898. https://doi.org/10.1007/s00192-018-3597-3
8. Sferra R., Pompili S., D'Alfonso A., Sabetta G., Gaudio E., Carta G., Festuccia C., Colapietro A., Vetuschi A. Neurovascular alterations of muscularis propria in the human anterior vaginal wall in pelvic organ prolapse. J Anat., 2019, Aug; № 235(2), рр. 281–288. https://doi.org/10.1111/joa.13014
9. Graul E., Hurst B. An alternative approach to the repair of cystoceles and rectoceles. Obstet gynecol, 2001, № 97, рр. 4.
10. Ayav A., Bresler L., Brunaud L. et al. Long-Term Results of Transanal Repair of Rectocele Using Linear Stapler. Dis Colon Rectum, 2004, № 47, рр. 889–894. https://doi.org/10.1007/s10350-004-0527-x
11. Boccasanta P., Venturi M., Calabrò G., Trompetto M., Ganio E., Tessera G., Bottini C., Pulvirenti D'Urso A., Ayabaca S., Pescatori M. Which surgical approach for rectocele? A multicentric report from Italian coloproctologists. Tech Coloproctol., 2001, Dec; № 5(3), рр. 149–156. https://doi.org/10.1007/s101510100017
12. Volozhin A.I., Topolnitsky O.Z., Shekhter A.B., Dorofeeva E.I., Zuikov Yu.A., Tarasenko S.V. Features of healing of the oral mucosa during wound application with a scalpel, laser and radionog (experimental study). Russian Dentistry, 2011, № 4(1), pp. 12–-18. (In Russ.)
13. Gain Yu.M., Bordakov P.V., Shakhray S.V. et al. Experimental substantiation of the use of regenerative technologies and high-intensity laser radiation in the treatment of chronic perineal wounds. Surgery. Eastern Europe, 2023, № 4 (12), pp. 347–376. (In Russ.)
14. Athanasiou S., Pitsouni E., Cardozo L., Zacharakis D., Petrakis E., et al. Can pelvic organ prolapse in postmenopausal women be treated with laser therapy? Climacteric, 2021, № 24(1), рр. 101–106.
Review
For citations:
Cherepenin M.Yu., Lutkov I.V., Gorsky V.A., Bashkurov O.E. Modern surgical methods of rectocele treatment – laser method. Moscow Surgical Journal. 2026;(1):54-60. (In Russ.) https://doi.org/10.17238/2072-3180-2026-1-54-60
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