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. 2010 Jun;23(2):90-8.
doi: 10.1055/s-0030-1254295.

Rectocele

David E Beck  1 , Nechol L Allen
Affiliations

Rectocele

David E Beck et al. Clin Colon Rectal Surg. 2010 Jun.

Abstract

Rectoceles are common and involve a herniation of the rectum into the posterior vaginal wall that results in a vaginal bulge. Women with rectoceles generally complain of perineal and vaginal pressure, obstructive defecation, constipation, or the need to splint or digitally reduce the vagina to effectuate a bowel movement. Rectoceles are associated with age and parturition and arise from either a tear or stretching of the rectovaginal fascia, and can be repaired via a vaginal, anal, or perineal approach. Although the rate of successful anatomic repair is high, reports of functional outcome are more variable.

Keywords: Rectocele; defecation disorders; posterior colporrhaphy.

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Figures

Figure 1
Figure 1
Rectocele. (A) High rectocele; (B) mid-rectocele; (C) low rectocele.
Figure 2
Figure 2
Enterocele.
Figure 3
Figure 3
Measurements of anorectal angle (ARA), perineal descent (PD), and rectocele diameter can be obtained from defecography.
Figure 4
Figure 4
Rectocele diameter is the distance between the interpolated anterior anorectal axis and the anterior-most portion of the rectocele.
Figure 5
Figure 5
Transvaginal repair.
Figure 6
Figure 6
Transperineal rectocele repair. (A) Surgical repair is performed using the perineal approach, through a U-shaped incision. (B, C) Redundant vaginal mucosa is retracted and resected. (D) Resected vaginal wall is sutured closed (inferiorly) and lateral rectovaginal fascia is plicated with sutures. The skin is closed without drainage.
Figure 7
Figure 7
Transanal repair. (A) Anal mucosa is excised; (B) rectal wall is plicated; (C) mucosa is closed.
See this image and copyright information in PMC

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