Rectocoele

A rectocele or posterior vaginal wall prolapse results when the rectum herniates into or forms a bulge in the vagina. This can occur in males also. When there is a tear in the rectovaginal septum due to childbirth or hysterectomy, the rectal tissues bulge through this tear into the vagina forming a hernia.

Sense of pressure/protrusion within vagina or feeling of rectum not emptied completely after bowel movement (Mild rectocoele)
Difficulty in passing stool, discomfort/pain during evacuation, intercourse, constipation (moderate rectocoele)
General sensation of falling out or falling down within pelvis
Vaginal bleeding, intermittent fecal incontinence, rectal prolapse
Childbirth – rapid births or babies weighing more than 9 pounds
Episiotomy
Use of forceps during childbirth
Hysterectomy or pelvic surgery

Treatment of Rectocoele

Non Surgical Method

Pelvic floor exercises like kegel exercises
Stool softeners, hormone replacement therapy
Insertion of pessary into the vagina

Surgical method

Surgical option is recommended when non surgical methods do not work and the condition starts affecting the normal lifestyle of the patient. Some of the surgical options include:

Posterior colporrhaphy
Repairing / strengthening rectovaginal septum
Insertion of mesh
STARR surgery (Stapled Transanal Resection of Rectum) ( advanced and minimally invasive till date )

STARR Surgery

This procedure involves the use of one or more staplers to correct the anatomical abnormalities present in the anorectal region causing Rectocoele. It involves resection of rectal prolapse through anal canal using an instrument called PPH. By removing rectal prolapse, an anatomically normal rectum is rebuilt.

Minimally invasive surgery
No surgical cuts, stitches, scars
Day care procedure
Recovery in 3-4 days

Tests involved prior to performing STARR surgery :

Defecography
Colonoscopy

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