{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:41:37Z","timestamp":1777905697512,"version":"3.51.4"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Kasr El-Aini Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between October 2023 and June 2025, 25 women with symptomatic Baden\u2013Walker grade II\u2013III 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\u2009\u00b1\u200910\u00a0mL). Outcomes included rectocele size on magnetic resonance (MR) defecography, clinical Baden\u2013Walker grade, predefined ODS symptom categories\/defecation frequency, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean rectocele size decreased from 3.28\u2009\u00b1\u20090.82 to 1.82\u2009\u00b1\u20090.47\u00a0cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-026-03322-8","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:46:29Z","timestamp":1777639589000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of autologous fat injection as a minimally invasive technique for rectocele repair: a prospective pilot study"],"prefix":"10.1007","volume":"30","author":[{"given":"I. A.","family":"Shafik","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M.","family":"Abdelfatah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"A.","family":"Shafik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Hagagy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"issue":"1","key":"3322_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/AOG.0000000000000057","volume":"123","author":"JM Wu","year":"2014","unstructured":"Wu JM, Vaughan CP, Goode PS, Redden DT, Burgio KL, Richter HE, Markland AD (2014) Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol 123(1):141\u2013148. https:\/\/doi.org\/10.1097\/AOG.0000000000000057. (PMID: 24463674; PMCID: PMC3970401)","journal-title":"Obstet Gynecol"},{"issue":"2","key":"3322_CR2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1097\/01.AOG.0000151990.08019.30","volume":"105","author":"Y Abramov","year":"2005","unstructured":"Abramov Y, Gandhi S, Goldberg RP, Botros SM, Kwon C, Sand PK (2005) Site-specific rectocele repair compared with standard posterior colporrhaphy. Obstet Gynecol 105(2):314\u2013318","journal-title":"Obstet Gynecol"},{"issue":"2","key":"3322_CR3","first-page":"229","volume":"30","author":"E N\u00fcssler","year":"2019","unstructured":"N\u00fcssler E, Gran\u00e5sen G, Bixo M, L\u00f6fgren M, Samuelsson E (2019) Repair of recurrent rectocele with posterior colporrhaphy or non-absorbable polypropylene mesh\u2014Patient-reported outcomes at one-year follow-up. Int Urogynecol J 30(2):229\u2013236","journal-title":"Int Urogynecol J"},{"issue":"Suppl 4","key":"3322_CR4","first-page":"S385","volume":"8","author":"E Mironska","year":"2019","unstructured":"Mironska E, Digesu GA, Slack M, Khullar V (2019) Recent advances in pelvic floor repair. Transl Androl Urol 8(Suppl 4):S385\u2013S396","journal-title":"Transl Androl Urol"},{"issue":"2","key":"3322_CR5","doi-asserted-by":"publisher","first-page":"678","DOI":"10.3390\/jcm12020678","volume":"12","author":"O Gluck","year":"2023","unstructured":"Gluck O, Lachman E, Meir Y, Shmueli A, Levin G, Rottenstreich A (2023) Surgical treatment for rectocele by posterior-compartment repair: a prospective comparative study. J Clin Med 12(2):678","journal-title":"J Clin Med"},{"key":"3322_CR6","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.00158","volume":"11","author":"L Shukla","year":"2020","unstructured":"Shukla L, Yuan Y, Shayan R, Greening DW, Karnezis T (2020) Fat therapeutics: the clinical capacity of adipose-derived stem cells. Front Pharmacol 11:158","journal-title":"Front Pharmacol"},{"issue":"1","key":"3322_CR7","first-page":"e1690","volume":"14","author":"Y Sowa","year":"2022","unstructured":"Sowa Y, Maehara T, Ikarashi S et\u00a0al (2022) Roles of adipose-derived stem cells in cell-based therapy. Dermatoendocrinol 14(1):e1690","journal-title":"Dermatoendocrinol"},{"issue":"9","key":"3322_CR8","first-page":"1240","volume":"14","author":"X Wu","year":"2020","unstructured":"Wu X, Li L, Wang Q et\u00a0al (2020) Tissue engineering in female pelvic floor reconstruction. J Tissue Eng Regen Med 14(9):1240\u20131255","journal-title":"J Tissue Eng Regen Med"}],"container-title":["Techniques in Coloproctology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10151-026-03322-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03322-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03322-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:59:11Z","timestamp":1777640351000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10151-026-03322-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["3322"],"URL":"https:\/\/doi.org\/10.1007\/s10151-026-03322-8","relation":{},"ISSN":["1123-6337","1128-045X"],"issn-type":[{"value":"1123-6337","type":"print"},{"value":"1128-045X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"7 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was approved by the Cairo University Faculty of Medicine Research Ethics Committee (approval no. MD-260\u20132022) and was conducted in accordance with the principles of the Declaration of Helsinki (2013 revision).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all participants prior to inclusion in the study. Consent was also obtained for the use of anonymized intraoperative photographs and illustrative figures.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The trial was prospectively registered on ClinicalTrials.gov under the identifier NCT06604702 (\u201cFat injection for rectocele treatment: a novel approach\u201d).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial registration"}}],"article-number":"58"}}