Evaluation of mesh perineoplasty in cases of perineal descent syndrome with preoperative assessment of the size of the perineal body : A prospective cohort study /
Mahmoud Adel Abu Alwafa,
Evaluation of mesh perineoplasty in cases of perineal descent syndrome with preoperative assessment of the size of the perineal body : A prospective cohort study / تقييم رأب العجان بشبكه في حالات متلازمة هبوط العجان مع تقييم حجم الجسم العجان قبل العمليه : دراسه مستقبليه by Mahmoud Adel Abu Alwafa ; Supervised Prof. Dr. Ali Ahmed Shafik, Dr. Mohamed Yehia Ahmed, Dr. Osama Refaie Mohamed, Dr. Mohamed Tamer Mohamed. - 113 pages : illustrations ; 25 cm. + CD.
Thesis (Ph.D)-Cairo University, 2025.
Bibliography: pages 95 -113.
Background: While Current surgeries target rectocele and
intussusception in patients with obstructed defecation syndrome (ODS),
excessive perineal descent may contribute to surgical failure. This study
evaluated the effectiveness of mesh perineoplasty, a procedure designed
to reinforce the perineum, in patients with ODS and abnormal PD.
Methods: Twenty-nine patients (20 females, 9 males; mean age 43.17 ±
10.7 years) with ODS and PD were assessed preoperatively using the
Cleveland Constipation Score (CCS), perineometer, anorectal manometry,
and MRI defecography. All underwent mesh perineoplasty and were
followed up for 6 months.
Results: Significant improvements were noted postoperatively. The CCS
decreased from 18.0 ± 3.21 to 12.69 ± 4.65 (P < 0.001), intrarectal
pressure increased from 34.34 ± 6.03 mmHg to 41.17 ± 5.85 mmHg (P <
0.001), and mean perineal descent improved from 2.29 ± 0.55 cm to 1.74
± 0.51 cm (P < 0.001). However, 9 patients (31%) reported persistent
symptoms. All had rectal intussusception, and all symptomatic females
had uterine prolapse with greater descent. They also exhibited smaller
perineal body dimensions, greater PD, and were older than the improved
group (mean age 55.67 vs. 37.55 years; P < 0.001).
Conclusion: Mesh perineoplasty is a promising procedure for patients
with ODS and excessive PD. However, factors intussusception, uterine
prolapse, older age, and smaller perineal body dimensions may predict
poorer outcomes, stressing the need for personalized surgical planning. متلازمة التبرز الانسدادي هي نوع من الإمساك يتميز ببراز مجزأ، والحاجة إلى الإجهاد عند التبرز، والشعور بعدم اكتمال البراز. يمكن ملاحظة سقوط العجان في 75% إلى 84% من مرضى متلازمة التبرز الانسدادي. لقد افترضنا أن المرض قد يكون مسؤولاً عن فشل معظم العمليات. الهدف من دراستنا هو تقييم النتائج السريرية والمورفولوجية والوظيفية الأولية قصيرة المدى لإجراء جراحي جديد، الدعم العجاني المستعرض (رأب العجان الشبكي) لتصحيح الحالة المرضية لدى مجموعة مختارة من المرضى.
Text in English and abstract in Arabic & English.
General Surgery
الجراحة العامة
Obstructed Defecation Syndrome Perineal Descent Mesh Perineoplasty Intussusception Rectocele Uterine Prolapse سقوط العجان انغلاق المستقيم
617
Evaluation of mesh perineoplasty in cases of perineal descent syndrome with preoperative assessment of the size of the perineal body : A prospective cohort study / تقييم رأب العجان بشبكه في حالات متلازمة هبوط العجان مع تقييم حجم الجسم العجان قبل العمليه : دراسه مستقبليه by Mahmoud Adel Abu Alwafa ; Supervised Prof. Dr. Ali Ahmed Shafik, Dr. Mohamed Yehia Ahmed, Dr. Osama Refaie Mohamed, Dr. Mohamed Tamer Mohamed. - 113 pages : illustrations ; 25 cm. + CD.
Thesis (Ph.D)-Cairo University, 2025.
Bibliography: pages 95 -113.
Background: While Current surgeries target rectocele and
intussusception in patients with obstructed defecation syndrome (ODS),
excessive perineal descent may contribute to surgical failure. This study
evaluated the effectiveness of mesh perineoplasty, a procedure designed
to reinforce the perineum, in patients with ODS and abnormal PD.
Methods: Twenty-nine patients (20 females, 9 males; mean age 43.17 ±
10.7 years) with ODS and PD were assessed preoperatively using the
Cleveland Constipation Score (CCS), perineometer, anorectal manometry,
and MRI defecography. All underwent mesh perineoplasty and were
followed up for 6 months.
Results: Significant improvements were noted postoperatively. The CCS
decreased from 18.0 ± 3.21 to 12.69 ± 4.65 (P < 0.001), intrarectal
pressure increased from 34.34 ± 6.03 mmHg to 41.17 ± 5.85 mmHg (P <
0.001), and mean perineal descent improved from 2.29 ± 0.55 cm to 1.74
± 0.51 cm (P < 0.001). However, 9 patients (31%) reported persistent
symptoms. All had rectal intussusception, and all symptomatic females
had uterine prolapse with greater descent. They also exhibited smaller
perineal body dimensions, greater PD, and were older than the improved
group (mean age 55.67 vs. 37.55 years; P < 0.001).
Conclusion: Mesh perineoplasty is a promising procedure for patients
with ODS and excessive PD. However, factors intussusception, uterine
prolapse, older age, and smaller perineal body dimensions may predict
poorer outcomes, stressing the need for personalized surgical planning. متلازمة التبرز الانسدادي هي نوع من الإمساك يتميز ببراز مجزأ، والحاجة إلى الإجهاد عند التبرز، والشعور بعدم اكتمال البراز. يمكن ملاحظة سقوط العجان في 75% إلى 84% من مرضى متلازمة التبرز الانسدادي. لقد افترضنا أن المرض قد يكون مسؤولاً عن فشل معظم العمليات. الهدف من دراستنا هو تقييم النتائج السريرية والمورفولوجية والوظيفية الأولية قصيرة المدى لإجراء جراحي جديد، الدعم العجاني المستعرض (رأب العجان الشبكي) لتصحيح الحالة المرضية لدى مجموعة مختارة من المرضى.
Text in English and abstract in Arabic & English.
General Surgery
الجراحة العامة
Obstructed Defecation Syndrome Perineal Descent Mesh Perineoplasty Intussusception Rectocele Uterine Prolapse سقوط العجان انغلاق المستقيم
617