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Gracilis muscle transposition for sexual dysfunction after proctectomy

, : Gracilis muscle transposition for sexual dysfunction after proctectomy. European Journal of Surgery 158(4): 245-246

Sexual dysfunction may follow protectomy for whatever disease (3, 5). Female patients experience dysfunction in sexual responses caused by damage to the pelvic nerves, analogous to erectional and ejaculation disturbances in men. In addition, 30-40% of women after protectomy may experience copious vaginal discharge and dyspareunia as a result of the backward dislocation and fixation of the upper vaginal and uterus to the sacrococcygeal bone (Fig.) (4, 5). These long term problems are more common than persistant perineal sinus, but there are many operations for the treatment of perineal sinus (1, 6, 7) and none for the treatment of gynaecological complaints. We describe the transposition of a gracilis muscle flap to correct the anatomical distorsion in two women aged 32 and 44 years, four and five years after extrasphincteric protectomy. Both had had copious vaginal discharge that required constant use of protective pad, and dyspareunia that had prohibited sexual intercourse since proctectomy. The typical pelvic anatomical changes that follow protectomy were recognized in both patients on gynaecological examination.


PMID: 1352140

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