Rectocele Repair: The Gynecologic Approach

Abstract

Gynecologists commonly perform rectocele repairs to address a herniation of the rectum into the posterior vaginal wall which results in a vaginal bulge. Women with rectoceles generally complain of perineal and vaginal pressure, obstructive defecation, constipation, and the need to splint or digitally reduce the vagina in order to effectuate a bowel movement. Rectoceles arise from either a tear or stretching of the rectovaginal fascia, and are commonly repaired by gynecologists via a posterior colporrhaphy. Although there are high rates of anatomic cures, there are conflicting reports with regard to functional outcome and many report postoperative dyspareunia. A modified repair, the discrete fascial defect repair, shows promising anatomical and functional results. KEYWORDS Rectocele - posterior colporrhaphy - site-specific defect rectocele repair - dyspareunia - defecation disorders