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Volume 7, Issue 10 (Suppl) Gynecol Obstet (Sunnyvale), an open access journal
ISSN: 2161-0932 Gynecology 2017
October 02-04, 2017
4th International Conference on
Gynecology & Obstetrics
October 02-04, 2017 Barcelona, Spain
Transverse perineal support: A novel surgical treatment for perineal descent in patients with
obstructed defecation syndrome
Adolfo Renzi
Villa delle Querce Hospital, Italy
Background: We hypothesized that pathological perineal descent may be responsible for the failure of operations for obstructed
defecation syndrome and that correcting excessive perineal descent may improve the outcome in this group of patients.
Objective: To report the short-term preliminary results of a novel surgical procedure, Transverse Perineal Support, for the correction
of pathological perineal descent.
Method: Prospective, uncontrolled, open-label study was conducted in a hospital and a university center. Among 25 patients observed
with failure of previous surgery for obstructed defecation syndrome, 12 with pathological perineal descent underwent Transverse
Perineal Support, were followed-up at 6 months and constituted the object of analysis. Interventions: The surgical procedure was
performed positioning a porcine dermal implant just above the perineum superficial fascia sutured to the periosteum membrane of
ischiatic tuberosities at the insertion of the superficial transverse perineal muscle. Main Outcome Measures: The main outcome
measures were: obstructed defecation syndrome score, X-ray and magnetic resonance defecographic imaging evaluation of perineal
descent and ano-rectal manometric parameters.
Results: Postoperative median obstructed defecation syndrome score was 7.0(3-8), showing a statistically significant difference if
compared with the preoperative one, 13.5(9-18), (P=0.0005). The mean postoperative maximum intrarectal pressure was 69.4(11.1)
mmHg, significantly higher than the preoperative one, 45.9(12.8), (P<0.0001). At postoperative X-ray and magnetic resonance
imaging defecography, the mean fixed and dynamic perineal descent were significantly lower than the preoperative ones (P=0.02 for
fixed perineal descent and P=0.0004 for dynamic perineal descent). Out of the four patients (33.3%) with preoperative pathological
dynamic perineal descent, only 1 showed a persistent pathological dynamic perineal descent. No early or late complication was
observed.
Limitations: The study was limited by its small size and short follow-up time.
Conclusions: Transverse Perineal Support would appear to be a promising, safe and effective procedure in the treatment of obstructed
defecation syndrome associated with pathological perineal descent.
Biography
Dr. Adolfo Renzi, graduated in Medicine and Surgery (1996) and specialized in General Surgery (2002) at the Faculty of Medicine of the Second University of
Naples. At the same university he obtained the title of Doctor in Research (2006). Colonoscopy training has matured, as a research fellow, at the Department of
Color Surgery at Cleveland Clinic Florida, USA (2000). Author of several scientific papers, published in national and international journals, has conducted research
at the Second University of Naples, dealing mainly with advanced laparoscopic surgery and post-operative early feeding. He is currently Chirurgical Group Manager
and is Coordinator of the Colon Pathology Unit "Pelvic Care Center" at the Clinica Villa delle Querce di Napoli. Inotre, he is the President of the Italian Society of
Colon Proctology (SIUCP).
Adolfo Renzi, Gynecol Obstet (Sunnyvale) 2017, 7:10(Suppl)
DOI: 10.4172/2161-0932-C1-021