Repair of rectocele

Repair of rectocele

Under normal conditions in women, the rectum is maintained in place by a layer of tissues ( pre-rectal fascia) between the rectum and the vagina. When these tissues are stretched and/or become weak with childbirth and ageing, the rectum displaces and bulges through this layer into the vagina. This results in a bulge felt in the lower part of the vagina at the back, also called rectocele. In severe cases, the bulge can be felt and seen at the opening of the vagina.

Surgical repair of the rectocele is done by making an incision in the vaginal wall over the bulging rectum. The rectum is dissected away from the vagina and replaced in position. The tissues (pre-rectal fascia) between the rectum and the vagina are strengthened by application of multiple plicating sutures which also improves the tone of the vaginal walls. The cut edges of the vagina are repaired. All sutures absorb over time and do not removing. Surgical mesh and grafts are not used, since research suggests no benefit from these materials.

You’ll probably need to stay in hospital overnight or for a few days following surgery. You are likely to have a thin flexible tube, a urinary catheter, to help you pass urine as you may find it difficult to do that yourself relating to postoperative pain. The catheter is removed 12 -24 hours later following which you should be able to pass urine satisfactorily.

You may also have a long piece of gauze placed inside the vagina to put pressure on the vaginal edges. This can be uncomfortable but is removed after 12 hours.

For the first few days or weeks after the operation, you may have some vaginal bleeding or discharge, and during this time you would use sanitary towels and not tampons.

You should be able to have a shower and bathe as normal once you have left the hospital, but you may need to avoid swimming for 6 weeks.

It’s best to avoid having sex for around 4 to 6 weeks, until you have healed completely.

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Mr Alak Pak

Mr Alak Pal

Mr Alak Pal is a senior Consultant Gynaecologist at the London North West University Healthcare NHS Trust with extensive experience in the management of utero-vaginal prolapse and urinary symptoms, menstrual disorders and pelvic pain, cysts in the ovary, endometriosis and fibroids. Read more…

Consulting at:

Clementine Churchill Hospital, Harrow

The Syon Clinic, Brentford

Portland Hospital, London.

Spire Thames Valley Hospital, Wexham

Princess Margaret Hospital, Windsor