Does laparoscopic rectopexy for complex rectocoele help to alleviate dyspareunia?: LTP50

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Aim: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.Method: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).Results: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.Conclusion: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.

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