Patients may require posterior repair when they have been diagnosed with a condition called rectocele. Also known as posterior prolapse, this problem is characterized by the weakening of the wall between the vagina and the rectum. This wall is made of fibrous tissues called fascia, and when experiencing a loss of strength can cause the rectum wall to fall and bulge into the vaginal area.
This condition can be caused by a variety of reasons. In many cases, childbirth can put undue pressure on the fascia and cause posterior prolapse. Pressure on the pelvic floor can contribute to this condition as well as chronic constipation, continual heavy lifting, and being overweight. Those with poor supporting muscles of the rectum are more likely to develop rectocele than those with strong ligaments and fascia. Genetics and aging can also be a factor.
When minor, patients may not be aware of the condition. However, when severe, the bulge can be noticeable and uncomfortable. Other symptoms include difficulties with bowel movements, feeling of a full rectum, and the need to push the bulge with the fingers to encourage bowel movements. Many patients may require surgical posterior repair when their rectocele is moderate or severe.
Whenever a patient is experiencing the above symptoms, an examination is required for proper diagnosis. Diagnosis requires a pelvic exam, information gathered from the doctor during discussions with the patient, and imaging tests for further evaluation of the rectal area.
There are ways for patients to change their lifestyle and reduce the problems associated with this condition. Patients are encouraged to perform Kegel exercises regularly to strengthen their pelvic muscles. High-fiber foods and fluids should be part of a well-balanced diet to avoid constipation and problems associated with difficult bowel movements. Staying at a healthy weight and avoiding heavy lifting can reduce symptoms. While pessaries may also assist in supporting the rectum, it is not an appropriate solution for everyone. Instead, surgical procedures such as rectocele repair may be required. This is often the suggested alternative for those who are extremely uncomfortable with severe posterior prolapse.
Dr. Gandhi of Partners in Pelvic Health North Shore Urogynecology offers posterior repair, as well as anterior repair and apical suspension, which are conditions that may also occur along with rectocele. If you believe you are dealing with pelvic floor conditions such as these, do not hesitate to contact our practice and schedule an examination for further testing and proper diagnosis.