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PILES AND RECTOCELES
Author(s) -
Heslop JohnH.
Publication year - 1987
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1987.tb01297.x
Subject(s) - medicine , perineum , surgery , asymptomatic , occult , inflatable , deformity , physical examination , episiotomy , pathology , biology , engineering , genetics , mechanical engineering , pregnancy , alternative medicine
Symptomatic rectocele is known to contribute to the formation of piles in female patients. This paper describes a subset of women pile sufferers who have occult rectoceles which are asymptomatic, and which are not obvious on routine visual examination, even with the use of the speculum. These patients are mulatiparous and have sustained perinea! damage either from episiotomy or from laceration. They present with symptoms of piles. If treated by conventional pile surgery the postoperative course is beadevilled with difficult defaecation, the patient often needing to insert a finger into the vagina to gain satisfactory evacuation. An accurate case history will show all these patients to have a pre‐operative story of straining at stool. Anterior rectal wall pressure on rectal examination shows a definite occult rectocele (spinnaker deformity) coupled with a deficient scarred perineum. This paper describes is such patients who have been seen over the past 4 years. Treatment has been by either pile surgery and later colpo‐perineorrhaphy (four cases), by combined colpo‐perineorrhaphy and pile surgery (eight cases), or by surgical correction of the rectocele alone (three cases).