Minimally invasive ventral mesh rectopexy for complex rectocoele: impact on anorectal and sexual function
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Bibliographic record
Abstract
AIM: Minimally invasive surgery for pelvic floor prolapse has recently been shown to be feasible and safe. This study presents the results of robotic-assisted and laparoscopic rectopexy for complex rectocoele, focusing on less frequently reported outcomes of bowel and sexual function. METHOD: We prospectively assessed 41 consecutive patients who underwent ventral mesh rectopexy (robotic-assisted or laparoscopic) for a symptomatic complex rectocoele from January 2009 to January 2010. Complex rectocoele was defined as having one or more of the following features: larger than 3 cm, an enterocoele or internal rectal prolapse. Patients with cystocoele underwent bladder suspension concurrently. Both groups were assessed for anatomical recurrence and function, comparing preoperative and postoperative faecal incontinence, obstructive defaecation syndrome and Gastrointestinal Quality-of-life Index scores, as well as vaginal discomfort and sexual function. RESULTS: Forty-one women underwent the procedure (16 robotic-assisted), with four (10.5%) having minor complications and two developing anatomical recurrence. There was significant relief of the commonest predominant symptoms of vaginal bulge/fullness (P<0.0001) and sexual dysfunction (P=0.02). There were three conversions to laparotomy (one robotic-assisted) and five patients declined postoperative functional assessment. In the remaining 33 patients [follow-up median 12 (8-21) months], analysis revealed no significant difference in overall functional score (P>0.740) or between patients with one or two meshes inserted (P>0.486). Only patients with a preoperative obstructive defaecation syndrome score >6 had a significant improvement postoperatively (P=0.030). CONCLUSION: Minimally invasive ventral mesh rectopexy for complex rectocoele offers satisfactory anatomical correction and functional results, with the potential for alleviating symptoms of outlet obstruction and improving vaginal comfort and sexual dysfunction.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it