Skip to main content
. 2018 Mar 5;2018(3):CD012975. doi: 10.1002/14651858.CD012975

Kahn 1999.

Methods Single‐centre RCT (number table randomisation, concealment unclear)
 Follow‐up: 25 months (8‐37) A+B
89% followed up
Participants 63 randomised, 57 underwent surgery (2 from each group decided on conservative management, 1 had no prolapse at time of surgery, and 1 delayed surgery past duration of study owing to personal circumstances)
 Withdrawal: 4 (A 2, B 2)
 Excluded: 2 (1 no rectocele surgery because posterior vaginal wall cyst, 1 did not have surgery performed)
 Inclusion: symptomatic rectocele (bulge or impaired defecation with > 15% trapping on isotope defecography), failing conservative treatment
Interventions A (24): posterior colporrhaphy with levator plication, enterocele repair, hysterectomy, anterior repair as required
 B (33): transanal repair by single colorectal surgeon, circular muscle plicated longitudinally, permanent suture
Outcomes

  • Awareness of prolapse

  • Repeat surgery for prolapse

  • Recurrent posterior vaginal wall prolapse

  • Bowel function

    • Postoperative obstructed defecation

  • Sexual function

    • Postoperative dyspareunia

  • Adverse events

    • Postoperative complications including wound infection

  • Perioperative outcomes ‐ continuous

  • EBL

  • Operating time

  • Length of stay

    • Postoperative narcotic use

  • Perioperative outcomes ‐ dichotomous

    • Persistent postoperative pain
Notes Abstract
No blinding
 No stratification
 No CONSORT
 Individual who reviewed outcomes unclear
 No validated symptom or QOL questionnaires
USA
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Number table randomisation
Allocation concealment (selection bias) Unclear risk Unclear
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Patients not blinded
Blinding of outcome assessment (detection bias) 
 All outcomes High risk Assessors not blinded
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No patients who underwent surgery lost to follow‐up ‐ see above
Selective reporting (reporting bias) Unclear risk Reported on all primary outcomes of this review, protocol not available
Other bias Low risk COI not reported
No concomitant procedures