Rectocele Surgery

Rectocele Surgical Treatment – Clinical Guide

What is a Rectocele?

A rectocele is a herniation of the rectum into the posterior vaginal wall. It develops as a result of pelvic floor weakness and primarily manifests with defecation problems.

Surgical Indications

• Advanced prolapse
• Severe defecation difficulty
• Vaginal fullness sensation
• Failure to respond to conservative treatment

Surgical Aim

To strengthen the supportive tissue between the rectum and the vagina and restore the anatomical structure.

1. Posterior Colporrhaphy

It is the most commonly performed surgery. The posterior vaginal wall is repaired, and the rectovaginal fascia is strengthened.

Advantages

• Performed via the vaginal route
• Minimally invasive
• Provides significant symptom improvement

Disadvantages

• Pain during sexual intercourse may occur if over-tightening
• Risk of recurrence exists

2. Site-Specific Repair

It is a more targeted surgery where fascial defects are specifically repaired.

3. Mesh Repair

Support is provided with synthetic material, but its use is limited today due to the risk of complications.

4. Transanal Approach

In some selected patients, surgical techniques performed via the rectal route may be applied.

Combined Surgeries

Since rectocele often coexists with cystocele or uterine prolapse, combined surgeries may be planned.

Post-Surgery

• Constipation should be avoided
• Fiber-rich diet is recommended
• Heavy lifting should be avoided
• Sexual intercourse is not recommended for 4–6 weeks

Complications

• Infection
• Pain
• Dyspareunia
• Recurrence

Clinical Fact

Correct patient selection and surgical technique are crucial for a successful outcome.

Conclusion

Rectocele surgery significantly reduces symptoms in appropriate patients. A multidisciplinary approach may be required.