Abstract: Objective To analyze the efficacy of autologous tissue repair for rectocele through the perineal approach in treating constipation and fecal incontinence in patients.Methods From January 2021 to November 2022, 23 female patients with symptomatic rectal protrusion were treated with perineal autologous tissue repair.Preoperatively and at 12 months postoperatively,the Cleveland Clinic Constipation Score (CCCS), Cleveland Clinic Incontinence Score (CCIS), and Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaires were used to assess postoperative outcomes and quality of life.Results Among the 23 patients,with a median follow-up time of 12.6 months,CCCS decreased from 17.09±1.68 to 3.96±2.08 (P<0.05);CCIS decreased from 1.52±4.15 to 0.52±1.41 (P>0.05);PAC-QOL:physical discomfort decreased from 13.00±1.51 to 4.74±1.98 ;psychological discomfort decreased from 20.96±3.27 to 5.74±2.67 ;concern and anxiety decreased from 26.13±4.37 to 8.78±3.14 ;satisfaction decreased from 15.39±2.35 to 4.60±1.59 (P<0.05).All patients showed significant improvement in constipation and incontinence symptoms postoperatively,with no serious postoperative complications and a marked improvement in postoperative quality of life.Conclusion Rectocele repair with perineal approach using autologous tissue is an effective and safe method,avoiding potential potential complications associated with grafts.

Key words: rectocele, constipation, perineal approach, utologous tissue repair