Injection sclerotherapy using aluminum potassium sulfate and tannic acid in the treatment of symptomatic rectocele: A prospective case series  Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Yoshiaki Ebisawa  International Journal of Surgery  Volume 30, Pages 94-98 (June 2016) DOI: 10.1016/j.ijsu.2016.04.039 Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 1 Defecography of patient No.6 observed at pushing phase. The measured size of rectocele (white arrow) is perpendicular to the axis of the anal canal (white line). An approximately 3.5-cm large rectocele was observed before injection sclerotherapy (A). The size of rectocele was decreased after the procedure (approximately 1.5 cm) (B). International Journal of Surgery 2016 30, 94-98DOI: (10.1016/j.ijsu.2016.04.039) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 2 Aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy. Rectocele was visible as a bulge in the posterior vaginal wall even at rest (A). In case of rectocele with rectal intussusception, the rectum was prolapsed to its maximum extent using forceps. ALTA solution was then injected along the rectal submucosa from the tip of the prolapsed rectum to the dentate line (B). In the case of rectocele with hemorrhoids, ALTA solution was injected using a proctoscope (C). The edematous anterior rectal wall was visible after sclerotherapy (D). International Journal of Surgery 2016 30, 94-98DOI: (10.1016/j.ijsu.2016.04.039) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 3 Probability of no recurrence with time for patients who underwent injection sclerotherapy. International Journal of Surgery 2016 30, 94-98DOI: (10.1016/j.ijsu.2016.04.039) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions