Transperineal rectocele repair with porcine dermal collagen implant. A two-year clinical experience

Purpose: Symptomatic rectocele results in obstructed defecation and constipation. Surgical repair may provide symptomatic relief. A variety of both synthetic and nonsynthetic graft materials have been used in the rectocele repair to enhance anatomical and functional results, and to improve long-term outcomes. Methods: In this prospective study we treated a series of 10 women suffering from symptomatic rectocele with transperineal repair using porcine dermal acellular collagen matrix BioMesh (PelvicolTM). Results: Follow-up ranged from 2 to 20 months and all patients demonstrated good anatomical results; thus far there have been no difficulties with delayed healing. There were no major intraoperative or postoperative complications (infection, abscess, hematoma, either vaginal or rectum injury, transfusion). There have been no complaints related to bowel function, and those patients who were sexually active prior to surgery have not experienced problems with sexual function or dispareunia. Conclusions: Rectocele repair with Permacol® by the transperineal approach seems an effective and safe procedure that avoids some of the complications associated with synthetic mesh use. Randomized prospective studies with long-term follow-up and documentation of both safety and efficacy using validated questionnaires and quality of life surveys are warranted to confirm these results.