Rectocele

Rectocele is a bulge of the rectum forwards into the vagina.  It occurs due to a weakness in the pelvic floor musculature.  Its incidence increases with age.  Patients might notice a difficulty in evacuating the bowels, and it can be associated with a condition termed obstructive defaecation syndrome.  Patients strain to open their bowels and might have to apply pressure directly into the vagina to be able to defaecate.

Investigations

Your surgeon will take a detailed history and perform a thorough physical examination.  A rectocele is detectable clinically.  However, before treatment is undertaken it is important to ensure that no other, more serious condition is accounting for your symptoms.  An investigation of the colon, either a colonoscopy or a scan is appropriate.  Further tests to investigate the pelvic floor such as a proctogram will also be undertaken.

Treatment

Often the symptom of constipation can be controlled through dietary modification and by taking laxatives.  However, if this is not effective surgery might be indicated.  Surgery either consists of a rectocele repair (a procedure performed through the anal canal to buttress the wall between the rectum and vagina), or a laparoscopic ventral rectopexy (keyhole surgery to pull the rectum straight and insert a mesh between the rectum and vagina).  Your surgeon will discuss with you the most appropriate treatment, as well as the potential risks and complications.

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