Rectocele Repair with or Without Internal Sphincter Botulinum Toxin Injection: a Prospective Randomized Trial

NCT ID: NCT06804993

Last Updated: 2025-02-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-31

Study Completion Date

2025-03-31

Brief Summary

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This is a single-centre, prospective randomized controlled trial on female patients with anterior rectocele associated with obstructed defecation syndrome

Detailed Description

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Conditions

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Obstructed Defaecation Syndrome Anterior Rectocele

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Transvaginal repair & botulinum toxin type A toxin injection

Group Type EXPERIMENTAL

Transvaginal repair & botulinum toxin type A injection

Intervention Type DRUG

100 units of lyophilized botulinum toxin type A were diluted in saline to 50 U/mL before the injections. A total of 30 units of type-A botulinum toxin was injected with a 22-G needle evenly divided in 3 sites, 2 on either side of the internal anal sphincter (3 and 9 O'clock) and the third anteriorly (at 12 O'clock)

Transvaginal repair & distilled water injection

Group Type PLACEBO_COMPARATOR

Transvaginal repair & distilled water injection

Intervention Type PROCEDURE

A total of 30 units of distilled water was injected with a 22-G needle evenly divided into 3 sites, 2 on either side of the internal anal sphincter (3 and 9 O'clock) and the third anteriorly (at 12 O'clock)

Interventions

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Transvaginal repair & botulinum toxin type A injection

100 units of lyophilized botulinum toxin type A were diluted in saline to 50 U/mL before the injections. A total of 30 units of type-A botulinum toxin was injected with a 22-G needle evenly divided in 3 sites, 2 on either side of the internal anal sphincter (3 and 9 O'clock) and the third anteriorly (at 12 O'clock)

Intervention Type DRUG

Transvaginal repair & distilled water injection

A total of 30 units of distilled water was injected with a 22-G needle evenly divided into 3 sites, 2 on either side of the internal anal sphincter (3 and 9 O'clock) and the third anteriorly (at 12 O'clock)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* female patients
* symptomatic rectocele
* failed conservative treatments for at least 3 months
* anterior rectocele larger than 3 cm in size in defecogram.
* retention of the contrast in the rectocele on defecography
* obstructed defecation manifestations: excessive straining, a sense of incomplete evacuation, the need for digital manipulation during defecation, or dyspareunia

Exclusion Criteria

* significant urinary manifestations due to anterior vaginal wall prolapse
* recurrent rectocele
* previous anal surgery
* slow-transit constipation
* faecal incontinence (FI)
* abnormal thyroid functions
* patients under systemic steroid treatment
* patients with connective tissue disease
* ASA classification \>3
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mansoura University

OTHER

Sponsor Role lead

Responsible Party

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Mostafa shalaby, MD, MSc, PhD

Associate Professor & Consultant Colorectal Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Mansoura University Hospital

Al Mansurah, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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MD.21.03.441

Identifier Type: -

Identifier Source: org_study_id

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