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Complex rectocoele may induce discomfort during intercourse. The benefit of an abdominal over a perineal approach to solving thisproblem remains controversial. This study aims to assess the impact of laparoscopic rectopexy on eventual satisfaction in patients withpreoperative dyspareunia.From Jan 2009 to Jan 2010, 41 patients underwent laparoscopic rectopexy for complex rectocele. The patients underwent a complete work-up, as well as an assessment of sexual activitypreoperatively and postoperatively (questionnaire BISF-W).After a mean follow-up of 6 ± 2 months, no de novo dyspareunia was noted. Ten patients (24%) of mean age 58 ± 7 years had dyspareuniapreoperatively, of whom seven had concomitant vaginal dryness and eight were menopausal. Postoperatively, eight of these 10 patients (80%) experienced an improvement in comfort levels during sexual intercourse, with an improvement in vaginal dryness noted in 30%. The mean BISF-W score was 22.4 in menopausal patients (normal 25) and 30.1 inpremenopausal women (normal 33), respectively.Laparoscopic rectopexy for complex rectocele did not result in de novo dyspareunia. In those withpre-existing dyspareunia, surgery even led to an improvement in comfort levels during sexual activity.