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Background <p>Rectocele repair remains challenging owing to high recurrence and morbidity associated with traditional surgical techniques. Autologous fat injection has emerged as a biologically integrative method that strengthens native pelvic tissues through regenerative mechanisms. This prospective pilot study evaluated feasibility, safety, and short-term anatomical and functional outcomes of autologous fat injection for rectocele repair.</p> Methods <p>Between October 2023 and June 2025, 25 women with symptomatic Baden–Walker grade II–III rectocele and obstructed defecation syndrome (ODS) were prospectively enrolled at Kasr Al-Ainy Hospital, Cairo University. Abdominal fat was harvested, mechanically emulsified, and injected into the rectovaginal septum using a 15-gauge blunt cannula (mean injected volume 52 ± 10&#xa0;mL). Outcomes included rectocele size on magnetic resonance (MR) defecography, clinical Baden–Walker grade, predefined ODS symptom categories/defecation frequency, and complications.</p> Results <p>Mean rectocele size decreased from 3.28 ± 0.82 to 1.82 ± 0.47&#xa0;cm (<i>p</i> &lt; 0.001). Overall, 80% of patients reported complete symptomatic improvement, while 20% reported recurrent symptoms during follow-up. Transient postoperative constipation occurred in 20% of patients and resolved conservatively. No major complications occurred. Injected volume showed an exploratory association with anatomical improvement.</p> Conclusions <p>Autologous fat injection for rectocele repair appears feasible and safe, with a signal of short-term anatomical and functional improvement in this pilot cohort. Larger comparative studies using validated patient-reported outcomes and standardized imaging follow-up are required.</p>

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Evaluation of autologous fat injection as a minimally invasive technique for rectocele repair: a prospective pilot study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月1日

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  • I. A. Shafik,
  • M. M. Abdelfatah,
  • A. Shafik Jr.,
  • E. Hagagy,
  • M. Ali

摘要

Background

Rectocele repair remains challenging owing to high recurrence and morbidity associated with traditional surgical techniques. Autologous fat injection has emerged as a biologically integrative method that strengthens native pelvic tissues through regenerative mechanisms. This prospective pilot study evaluated feasibility, safety, and short-term anatomical and functional outcomes of autologous fat injection for rectocele repair.

Methods

Between October 2023 and June 2025, 25 women with symptomatic Baden–Walker grade II–III rectocele and obstructed defecation syndrome (ODS) were prospectively enrolled at Kasr Al-Ainy Hospital, Cairo University. Abdominal fat was harvested, mechanically emulsified, and injected into the rectovaginal septum using a 15-gauge blunt cannula (mean injected volume 52 ± 10 mL). Outcomes included rectocele size on magnetic resonance (MR) defecography, clinical Baden–Walker grade, predefined ODS symptom categories/defecation frequency, and complications.

Results

Mean rectocele size decreased from 3.28 ± 0.82 to 1.82 ± 0.47 cm (p < 0.001). Overall, 80% of patients reported complete symptomatic improvement, while 20% reported recurrent symptoms during follow-up. Transient postoperative constipation occurred in 20% of patients and resolved conservatively. No major complications occurred. Injected volume showed an exploratory association with anatomical improvement.

Conclusions

Autologous fat injection for rectocele repair appears feasible and safe, with a signal of short-term anatomical and functional improvement in this pilot cohort. Larger comparative studies using validated patient-reported outcomes and standardized imaging follow-up are required.